All About Edema Or Brain Swelling

Brain swelling, or edema, is a very serious condition.  This is when the pressure inside your skull increases. Brain swelling can be caused by lots of different things.  There are five main types of different brain swelling that can occur. Brain swelling can prevent blood flow, block fluids from leaving the brain causing more pressure to build up, damage or death of the brain cells and can even cause death.  There are lots of things that can lead to brain swelling and you will need to be treated almost immediately for there to be no lasting effect. 

Brain swelling can be caused by lots of different things from infections to even the altitude.  The main cause of brain swelling is head trauma. This can include a traumatic brain injury as well.  Examples of this would be a concussion from a car crash, or fall. Infections in the brain can also lead to brain swelling, such as meningitis, or encephalitis. Other causes of brain swelling can be stroke, toxoplasmosis, subdural empyema, or tumors.  Mountain sickness can cause brain edema as well from the high altitude. There are many causes of brain swelling and some can be more dangerous than others.  

There are five main types of brain swelling:

Cytotoxic is one of the most common brain swellings.  This is when your brain holds onto sodium and water. This type is usually caused by traumatic brain injuries, infection, or ingestion of methanol or ecstasy. 

The second most common type is vasogenic. Vasogenic brain swelling is when the blood barrier of the brain doesn’t work properly. This type is caused by tumors or brain abscesses. 

The third type is interstitial which is caused by obstructive hydrocephalus.

The fourth type is hydrostatic which can be brought on by heart failure or chronic venous destruction.

Osmotic is the last type of brain swelling and it is when there is extra water that builds up in your brain cells that won’t drain.  Knowing which type you have will help your doctor prescribe the right treatment. 

There is a long list of symptoms of brain swelling. If you have any of these you will want to be seen by a doctor immediately.  The first 24-48 hours are crucial in the treatment process. Some symptoms include headache, neck pain, nausea, vomiting, dizziness, or irregular breathing.  Other symptoms are vision loss, memory loss, inability to walk, difficulty speaking, stupor, seizures, or loss of consciousness. Depending on what type of brain swelling you have will determine what symptoms you may show.  You could have some of these symptoms or a lot of them it is all dependent on how severe your brain injury is.  

If you present with any of these symptoms and your doctor believes you could have brain swelling there are a number of tests your doctor may do to diagnose you.  They will first start with a head and neck exam. After that your doctor will order a CT scan or an MRI or both to get pictures of your brain to see if there has been any damage done.  If you have suffered from a traumatic brain injury, one of the first things your doctor will order a CT or MRI. Other tests your doctor may rely on blood tests, or neurological exam. In the neurological exam, your doctor will test you for motor function, sensory function, and pupillary function.  It is important to tell your doctor if you are taking any prescription medication, whether it be over the counter medicines, or natural remedies. Also make sure you tell them if you are drinking alcohol, taking illicit drugs, or blood thinners.  

If you present with brain swelling the first 24-48 hours are crucial.  You will be monitored very closely to make sure that treatment is working and the swelling is decreasing.  Swelling is usually not recurrent unless you have a brain tumor or abscess. If you are being treated appropriately though, swelling should not come back after the first initial injury.  Some treatment options are oxygen therapy or IV fluids. Another treatment that isn’t used all the time is lowering body temperature, inducing hypothermia. This is a very hard treatment to do correctly so not many doctors will prescribe it.  Medication can be prescribed, such as pain relievers to help with symptoms. If the brain swelling is not decreasing in the first few hours or is so severe you may need surgery. You may need a ventriculostomy, which is when there is a hole drilled in your skull, a drain is placed to drain the excess fluid in your brain.  Another surgery option is to remove part of the skull to allow the brain room to swell and then to heal. Once the brain swelling has decreased a skull flap can be put over the hole so that your brain isn’t exposed. You will have to be very careful in this course of treatment because there will be a section of your brain that isn’t protected by your skull.   You may have to stay in the hospital during this time so that you can be monitored closely. There are surgeries that can help repair the source of swelling such as a damaged artery or vein in your brain. If you have a brain tumor steroids may be prescribed to help as well. In some cases rest is the best cure, no strenuous activity, no screens tv or phone, no reading, keep head elevated, and no focusing on anything for too long.  Time is important when it comes to brain injuries.  

As long as the brain swelling decreases within the first few hours of treatment you will know that treatment is working and your brain is on the mend.  Brain injuries can be severe and without appropriate care can be fatal. It can take time for your brain to fully heal. Even after the swelling has gone down there can be lasting effects.  Make sure you follow up with your doctor regularly so they can keep track of your progress. Do not get discouraged, it can take time after a brain injury to get back to your normal routine.