Cerebral edema (summary)

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This is a basic article for medical students and other non-radiologists

Cerebral edema describes the collection of additional fluid within the white matter of the brain. It is the brain's response to an insult and may take one of two broad forms: vasogenic (white matter) and cytotoxic (grey and white matter) edema.

Reference article

This is a summary article; read more in our article on cerebral edema.

Summary

  • pathophysiology
    • edema within the brain parenchyma (white and/or grey matter)
      • the result of a brain insult (ischemia/infarction, infection, tumor etc)
    • two main types of cerebral edema
      • cytotoxic
        • affects white and grey matter
        • blurring of the grey-white junction
        • usually the result of ischemia and/or infarction
      • vasogenic
        • affects white matter only
        • surrounds a mass, i.e. usually an abscess or a tumor
    • periventricular edema occurs secondary to acute hydrocephalus as CSF pressure builds and seeps into the periventricular white matter

Imaging

CT head | MRI brain

  • role of imaging
    • confirm the presence of edema
    • determine the likely underlying cause
    • determine whether there is sequela from any mass effect
  • radiographic features
    • compression and displacement of adjacent structures
    • change in parencymal density (CT) and signal (MRI)
      • reduced density (attenuation) on CT
      • high-signal on T2-weighted sequences (MRI)
      • low-signal on T1-weighted sequences (MRI)
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