Cerebral edema
Updates to Article Attributes
Cerebral oedema refers to a number of interconnected processes which result in abnormal shifts of water in 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 oedema and cytotoxic cerebral oedema, the latter a term commonly used to denote both true cytotoxic oedema and ionic oedema 4. In addition, although traditionally not included in discussions on oedema, haemorrhagic transformation can be thought of as an extreme end-stage form of the same processes which lead to oedema.
As such a more precise classification is 3-4:
Special types of oedema to be considered:
- transependymal oedema (also known as interstitial cerebral oedema)
- combined cerebral oedema
Treatment
Promising drugs for the pharmacological treatment of cerebral edema, in any clinical trial phase, include (but are not limited to) 5:
- Conivaptan (dual antagonist of AVP V1A and V2 receptors)
- Fingolimod (sphingosine-1-phosphate receptor modulator)
- Celecoxib (COX-2 inhibitor)
- Glyburide (antidiabetic sulfonylurea)
- Xerecept (human corticotropin-releasing factor / hCRF)
- Bevacizumab (humanized monoclonal VEGF-A inhibiting antibody)
- Cediranib (potent pan-VEGF RTK inhibitor)
-<p><strong>Cerebral oedema</strong> refers to a number of interconnected processes which result in abnormal shifts of water in various compartments of the brain parenchyma.</p><p>It has traditionally been broadly divided into <a href="/articles/vasogenic-cerebral-oedema">vasogenic cerebral oedema</a> and <a href="/articles/cytotoxic-cerebral-oedema">cytotoxic cerebral oedema</a>, the latter a term commonly used to denote both true cytotoxic oedema and ionic oedema <sup>4</sup>. In addition, although traditionally not included in discussions on oedema, haemorrhagic transformation can be thought of as an extreme end-stage form of the same processes which lead to oedema. </p><p>As such a more precise classification is <sup>3-4</sup>:</p><ul>- +<p><strong>Cerebral oedema</strong> refers to a number of interconnected processes which result in abnormal shifts of water in various compartments of the brain parenchyma. It is observed in the majority of injuries involving the central nervous system <sup>5</sup>.</p><p>It has traditionally been broadly divided into <a href="/articles/vasogenic-cerebral-oedema">vasogenic cerebral oedema</a> and <a href="/articles/cytotoxic-cerebral-oedema">cytotoxic cerebral oedema</a>, the latter a term commonly used to denote both true cytotoxic oedema and ionic oedema <sup>4</sup>. In addition, although traditionally not included in discussions on oedema, haemorrhagic transformation can be thought of as an extreme end-stage form of the same processes which lead to oedema. </p><p>As such a more precise classification is <sup>3-4</sup>:</p><ul>
- +</ul><h4>Treatment</h4><p>Promising drugs for the pharmacological treatment of cerebral edema, in any clinical trial phase, include (but are not limited to) <sup>5</sup>:</p><ul>
- +<li>Conivaptan (dual antagonist of AVP V<sub>1</sub>A and V<sub>2</sub> receptors)</li>
- +<li>Fingolimod (sphingosine-1-phosphate receptor modulator)</li>
- +<li>Celecoxib (COX-2 inhibitor)</li>
- +<li>Glyburide (antidiabetic sulfonylurea)</li>
- +<li>Xerecept (human corticotropin-releasing factor / hCRF)</li>
- +<li>Bevacizumab (humanized monoclonal VEGF-A inhibiting antibody)</li>
- +<li>Cediranib (potent pan-VEGF RTK inhibitor)</li>
References changed:
- 5. Stokum J, Gerzanich V, Sheth K, Kimberly W, Simard J. Emerging Pharmacological Treatments for Cerebral Edema: Evidence from Clinical Studies. Annu Rev Pharmacol Toxicol. 2020;60(1):291-309. <a href="https://doi.org/10.1146/annurev-pharmtox-010919-023429">doi:10.1146/annurev-pharmtox-010919-023429</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31914899">Pubmed</a>