Vasogenic cerebral edema

Last revised by Masoud Farhadi on 23 Feb 2024

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 blood-brain barrier remains intact). It is an extracellular edema which mainly affects the white matter via leakage of fluid from capillaries.

The causes are diverse, including neoplasm, infection, inflammation, hemorrhage, subacute arterial infarct, and venous infarct4.

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.

If the edema is bilateral and more widespread in particular then posterior reversible encephalopathy syndrome (PRES) should also be considered.

Radiographic features

CT
  • grey-white matter differentiation is maintained and the edema involves mainly white matter, extending in a 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)

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Cases and figures

  • Case 1: breast cancer metastases
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  • Case 2: lung cancer metastases
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  • Case 3 : lung cancer metastasis, cystic
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  • Case 4
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