Edema, Hydrocephalus, and Increased ICP Flashcards
What are the two physiologically distinct types of cerebral edema?
vasogenic
cytotoxic
Describe vasogenic cerebral edema
caused by increased leakiness of capillaries
Pathogenesis of cytotoxic cerebral edema
swelling of neuronal cells
What are the normal causes of cytotoxic cerebral edema?
hypoxia
cellular insult/metabolic damage
Two basic Tx options for vasogenic edema
steroids
mannitol
Mechanism of mannitol Tx
mannitol is simple sugar, IV admin, does not cross BBB so causes fluid to move from CSF back into systemic circulation and therefore decreases ICP
Mechanism of steroids
transcriptional level control of WBC, reduces # and therefore deceases inflammatory response
How do you treat cytotoxic cerebral edema?
no effective medical treatment
Hydrocephalus type caused by block of arachnoid granules
communicating hydrocephalus
CSF still able to move around entire ventricular system
Hydrocephalus type caused by block in ventricular system
noncommunicating hydrocephalus
CSF unable to move through entire ventricular system–leads to enlargement of 1+ ventricles
This phenomenon is referred to as a hydrocephalus type and follows brain atrophy–CSF fills empty damaged space
hydrocephalus ex vacuo
A choroid plexus papilloma causes this type of hydrocephalus
hydrocephalus due to increased CSF production
Normal pressure hydrocephalus is most common in what population
elderly
What are the three signs of normal pressure hydrocephalus
abnormal, wide gait
urinary incotinence
dementia
do not “care as much”
Two medications for treating ICP
acetazolamide
furosemide
