Tx Edema and Hydrocephalus

Question 1

Vasogenic edema

Answer 1

Cause: increased vascular permeability
Fluid shifts into intercellular spaces in brain
Localized or generalized

Question 2

Cytotoxic edema

Answer 2

Cause: cell membrane injury
Increased intracellular fluid
Typically seen in hypoxia or with metabolic damage

Question 3

Tx cerebral edema

Answer 3

steroids and osmotherapy (not diuretics, carbonic anhydrase inhibitors)

Question 4

steroid mechanism

Answer 4

anti-inflammatory –> reduce water permeability of tight junctions (intracellular receptor, transcription regulator - bind DNA, less VGEF made)
dexamethasone

Question 5

Mannitol mechanism

Answer 5

osmotic diuretic
small sugar that doesn’t cross BBB - so particles in blood > number of particles in cells/CSF –> pull water across membranes

Question 6

tx cytotoxic cerebral edema

Answer 6

none

Question 7

tx hydrocephalus

Answer 7

Reduce fluid volume and pressure
Shunt/surgery to remove blockage

Decrease CSF production (acetazolamide, furosemide)