Cerebral Edema
Type | Definition / Mechanism | Key Etiologies / Examples |
Vasogenic edema | Breakdown of the blood–brain barrier (BBB) → leakage of plasma and proteins into extracellular space (mainly white matter) | - Brain tumors (especially metastases, gliomas) - Abscesses - Inflammation (encephalitis) - Late ischemic stroke - Trauma |
Cytotoxic edema | Cellular swelling due to failure of Na⁺/K⁺ ATPase → water shifts into neurons, astrocytes, and glia (involves gray and white matter) | - Early ischemic stroke - Hypoxia / anoxia - Hypoglycemia - Toxic/metabolic insults (e.g., hepatic failure, poisoning) |
Interstitial (hydrocephalic) edema | Trans-ependymal flow of CSF into periventricular white matter due to elevated intraventricular pressure | - Obstructive (non-communicating) hydrocephalus - Shunt malfunction |
Ionic (Osmotic) edema | Low plasma osmolality causes water to move into brain parenchyma (intact BBB) →extracellular volume DECREASED | - Hyponatremia (including SIADH) - Rapid correction of hyperosmolar states - Dialysis disequilibrium syndrome |
Inflammatory edema (sometimes included under vasogenic) | BBB disruption from inflammatory cytokines and leukocyte infiltration | - Meningitis, encephalitis, autoimmune demyelination (MS, ADEM) |
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