0000000000132836
AUTHOR
Hans J. Reulen
The Effect of Dexamethasone on Water and Electrolyte Content and on rCBF in Perifocal Brain Edema in Man
The results of clinical studies are reported dealing with the relationship between cerebral edema and regional cerebral blood flow in patients with brain tumor as well as with the effect of dexamethasone on this relationship. rCBF is found to be significantly reduced in brain tissue surrounding brain tumors. Autoregulation as well as cerebrovascular reactivity to PaCO2 is focally or generally impaired. Water content of perifocal white matter is markedly increased. The combination of tissue lactacidosis, low regional blood flow and vasoparalysis seems to be a characteristic finding in this type of local brain edema. The increased local tissue pressure, due to the increased tissue water conte…
Clearance of Edema Fluid into Cerebrospinal Fluid
The formation of cerebral edema appears to be the response of the brain to injury from a diversity of causes, in association with tumors, trauma, and infections, as well as toxic, anoxic, and metabolic disorders. The classification by Klatzo14 of cerebral edema into two major categories, vasogenic edema and cytotoxic edema, has clarified our understanding of this pathological problem. A third category has been termed interstitial 10 or hydrocephalic 17 edema. The various processes are not mutually exclusive. In ischemic brain edema, changes characteristic of vasogenic and cytotoxic cerebral edema occur, and in subarachnoid hemorrhage, all three types of edematous changes may develop. Nevert…