Cerebral Edema (Brain Swelling)

What is cerebral edema?

“Cerebral edema“ is the medical term for brain swelling, or swelling that happens in part or all of your brain because of excessive fluid buildup in the tissue. Your skull protects your brain, but it can’t expand to hold extra fluid.

“Intracranial pressure“ is the term for pressure inside your skull. Cerebral edema can cause elevated intracranial pressure (ICP).

Many things can cause brain swelling, including head trauma, stroke, cancer and other diseases.

Swelling of the brain can be a serious condition, so it’s usually considered a medical emergency. Severe, untreated cases can be fatal.

Cerebral edema can happen to anyone, from infants to adults, and as the result of an injury or illness.

Types of cerebral edema

There are different types of cerebral edema. Major types include:

• Vasogenic: Tumors can cause this most common type of cerebral edema. It involves swelling outside of brain cells, and leaky blood vessels cause it.
• Cellular: This form of cerebral edema happens because of traumatic brain injury and stroke. Another name is cytotoxic edema. It occurs when brain cells don’t get enough blood or oxygen.

Less common types include:

• Osmotic: Conditions like diabetes-related ketoacidosis and hyponatremia can cause this type of cerebral edema.
• Interstitial: Hydrocephalus and meningitis can cause this type of cerebral edema.

How common is cerebral edema?

Cerebral edema can happen in many ways, so it’s a relatively common condition treated in hospitals.

What are the symptoms of cerebral edema?

When mild, you may have no symptoms. If you do develop cerebral edema signs and symptoms, they may include:

• Headache.
• Drowsiness or trouble thinking.
• Personality change.
• Pain or stiffness in your neck.
• Vomiting.
• Seizures.
• Visual disturbances, including double vision and blurred vision.
• Trouble speaking.
• Memory problems.
• Sudden high blood pressure.
• Breathing difficulties.
• Weakness.
• Loss of consciousness.

What causes cerebral edema?

Causes of swelling (edema) throughout your body vary, as do causes of cerebral edema. Brain swelling can happen because of an actual injury to your brain, infections and inflammatory conditions. Cerebral edema causes can include:

• Traumatic brain injury.
• Brain cancer.
• Diabetes-related ketoacidosis.
• Eclampsia.
• Encephalitis.
• Hemorrhagic stroke.
• Hepatic encephalopathy.
• Hydrocephalus.
• Ischemic stroke.
• Meningitis.
• Toxins that result from medications, poisons or venomous bites.
• Toxoplasmosis or other brain infections.
• Venous sinus thrombosis.
• Altitude sickness. The name for this form of cerebral edema is high-altitude cerebral edema (HACE).

Is cerebral edema contagious?

Cerebral edema isn’t a disease you can give to someone else or catch from someone else. However, infections that can be transmitted from person to person that can cause cerebral edema include:

• Meningitis.
• Encephalitis.
• Toxoplasmosis.

Even mild infections like sinusitis or ear infections can sometimes lead to pus accumulating in your skull and then to cerebral edema, although this is rare.

What are the risk factors for this condition?

One risk factor for developing cerebral edema is having diabetes, which puts you at further risk for developing diabetes-related ketoacidosis or infections that can cause edema. The risk is higher for children who have diabetes than for adults. People with cancer or a compromised immune system also have a higher risk of developing brain edema.

How is cerebral edema diagnosed?

Healthcare providers will talk to you or people around you and perform a neurological examination. Your history and symptoms can help a healthcare provider tell if you have cerebral edema. Brain imaging — either with a CT scan or MRI — can confirm the diagnosis of brain edema.

What tests will be done to diagnose cerebral edema?

A healthcare provider may order certain tests to diagnose swelling in your brain or the causes of the swelling, including:

• A computed tomography (CT) scan.
• A magnetic resonance imaging (MRI) scan.
• Blood tests.

How is cerebral edema treated?

The goal of cerebral edema treatment is to reduce the fluid buildup and swelling in brain tissues. There are a few mainstays of treatment, including medications and surgery.

Drugs that treat cerebral edema

Different types of brain swelling are treated in different ways. Depending on what’s causing the swelling, your provider may prescribe medications to manage cerebral edema, including:

• Corticosteroids.
• Mannitol and other diuretics.
• Hypertonic saline.
• Sedatives.
• Fever reducers.
• Blood thinners.

Procedures that treat cerebral edema

In severe cases, a neurosurgeon might treat brain swelling with procedures, including:

• Craniectomy: This is a surgery that removes part of your skull to relieve pressure.
• Ventriculostomy: This surgery creates a hole into a brain ventricle so a tube can let cerebrospinal fluid flow out of your brain into a collection bag.
• Shunting: This procedure moves fluid out of your brain and into your body so it can be reabsorbed safely.
• Surgical removal of a brain lesion.

Complications/side effects of treatments for cerebral edema

Typically, the complications of surgical procedures include infection and bleeding.

Medications can have side effects, too. Corticosteroids can have many side effects, including:

• Increased appetite and weight gain.
• Lower resistance to infection.
• Acne.
• Mood changes.
• Nervousness.
• Bruising more easily.

Side effects of mannitol and other diuretics may include:

• Dehydration.
• Kidney damage.

Can you recover from cerebral edema?

The short answer is yes. You can recover from cerebral edema. In addition to treating the brain swelling directly, you need to manage the condition that caused the swelling in the first place.

Can cerebral edema be prevented?

You can’t prevent every episode of cerebral edema, but you may be able to lower your risk. You can:

• See a primary care provider regularly for check-ups.
• Manage chronic conditions like diabetes and high blood pressure.
• Take medications as directed.
• Take care when playing sports that could cause concussions.
• Wear seat belts in motor vehicles and helmets when riding bikes and motorcycles.
• Get necessary vaccines and take other preventive healthcare measures.
• Practice measures to avoid infections, like avoiding people who are sick and washing your hands well.
• If you smoke, try to stop. Smoking increases your risk of having a stroke.

What can I expect if I have cerebral edema?

The prognosis (outlook) for brain swelling depends on many factors, including:

• The cause of the swelling.
• Your general health.
• Getting medical care for the edema quickly.

Treating the swelling and underlying cause may take some time. In addition, you may have to deal with conditions that result from the swelling.

When should I see a healthcare provider about cerebral edema?

If you have any type of brain injury, see a healthcare provider right away, even if it’s mild. If you have a concussion or head injury while playing sports, you must see a physician and can’t return to play until a healthcare provider says it’s OK.

If you have chronic conditions like diabetes or high blood pressure, and you have symptoms of fluid buildup and swelling in your brain, get immediate medical help.

What questions should I ask my healthcare provider about cerebral edema?

You may have questions for your healthcare provider about brain swelling, like:

• What’s the cause of the cerebral edema?
• What treatments do you recommend?
• How will you treat the underlying cause of the brain swelling?
• What are the side effects of treatment?