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A vasogenic edema is a type of cerebral edema that occurs when the blood-brain barrier is broken and fluid builds up in the intracellular or extracellular areas of the brain. It is often the result of trauma to the brain such as a head injury, tumor, brain hemhorrage or stroke, although it can also be caused by vascular or metabolic disease or infections, such as meningitis or encephalitis. Edemas of the brain can cause the brain to swell, requiring immediate medical attention.
Symptoms of a vasogenic edema include headache, blurred or lost vision, and pain or stiffness in the neck. Nausea or vomiting, seizures, and irregular breathing can occur, and difficulty speaking or walking, stupor, and loss of consciousness are more severe signs. The symptoms are usually sudden and may vary depending on the severity of the edema. A head and neck exam and a computed tomography (CT) or neurological scan may be used to determine the location and size of the problem, as well as the extent of any brain swelling, while a magnetic resonance imaging (MRI) and blood test to determine the cause of the edema may also be performed.
Treatment depends on the edema's severity and the timeliness of medical attention. The primary treatment objective is maintaining adequate blood and oxygen flow to the brain while relieving any swelling and treating the underlying cause of the edema. Various treatment options include oxygen therapy, where oxygen is provided through a respirator, intravenous-administered medication and fluids to control blood pressure and help fight off infection, and medication to alleviate brain swelling.
Other, more invasive treatment options include decompressive craniectomy, which involves surgically removing part of the skull to relieve intracranial pressure, or surgically repairing or removing the source of the swelling, such as a tumor. In some cases, a ventriculostomy may be performed. This procedure involves drilling a hole in the skull and inserting a plastic drain tube to capture cerebrospinal fluid from inside the brain in order to relieve cranial pressure. Another treatment option is inducing hypothermia by lowering body temperature to relieve brain swelling and allow the body to heal. Hypothermia is not widely used as a treatment for brain swelling because it can be difficult to perform correctly.
As with any type of brain trauma, there may be lingering after-effects of a vasogenic edema. Some of these effects include headaches, impaired cognitive and communication skills, and trouble with physical movements. Abrupt changes in sleeping patterns and depression can also occur. While some of the symptoms may diminish over time, others may require continued medical treatment and care to ensure a complete recovery.
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