Cerebral edema refers to a number of interconnected processes which result in abnormal shifts of water across various compartments of the brain parenchyma. It is observed in the majority of injuries involving the central nervous system 5.
It has traditionally been broadly divided into vasogenic cerebral edema and cytotoxic cerebral edema, the latter a term commonly used to denote both true cytotoxic edema and ionic edema 4. In addition, although traditionally not included in discussions on edema, hemorrhagic transformation can be thought of as an extreme end-stage form of the same processes which lead to edema.
As such, a more precise classification is 3,4:
osmotic cerebral edema
Special types of edema to be considered:
transependymal edema (also known as interstitial cerebral edema)
Treatment and prognosis
Promising drugs for the pharmacological treatment of cerebral edema in any clinical trial phase, include (but are not limited to) 5:
conivaptan, a dual antagonist of arginine vasopressin (AVP) V1A and V2 receptors
fingolimod, a sphingosine-1-phosphate receptor modulator
celecoxib, a COX-2 inhibitor
glyburide, an antidiabetic sulfonylurea
human corticotropin-releasing factor (hCRF)
bevacizumab, a humanized monoclonal VEGF-A inhibiting antibody
cediranib, a potent pan-VEGF RTK inhibitor
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