Combined cerebral edema is a type of cerebral edema in which there is a mixed pattern of different types of cerebral edema (cytotoxic, vasogenic or osmotic).
It is usually associated with severe systemic damage, such as:
hypertensive crises
severe sepsis / severe inflammatory condition
intoxication / metabolic systemic disease
brain trauma
Radiographic features
The radiographic features are those of both cytotoxic and vasogenic cerebral edema. Hence, both the grey and white matter are affected, with sulci effacement, loss of cortical differentiation and finger-like hypodensities (CT-scan) / hyperintensities (T2/FLAIR).
Treatment and prognosis
This finding usually carries a very poor prognosis.
A cerebral herniation is almost inevitable unless aggressive treatment of the underlying etiology is quickly initiated.
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