Vasogenic cerebral edema

Vasogenic cerebral edema refers to a type of cerebral edema in which the blood brain barrier (BBB) is disrupted (cf. cytotoxic cerebral edema, where the BBB is intact). It is an extracellular edema which mainly affects the white matter via leakage of fluid from capillaries.

It is most frequently seen around brain tumors (both primary and secondary) and cerebral abscesses, though some vasogenic edema may be seen around maturing cerebral contusion and cerebral hemorrhage.

Radiographic features

CT

• grey-white matter differentiation is maintained and the edema involves mainly white matter, extending in finger-like fashion
• secondary effects of vasogenic edema are similar to cytotoxic edema, with effacement of cerebral sulci, with or without midline shift

MRI

• hyperintense T2 and FLAIR signals, which do not show restricted diffusion ² (cf. cytotoxic cerebral edema, which shows diffusion restriction)