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Cerebral edema is a potentially life-threatening complication of severely decreased sodium ion concentration in the blood (hyponatremia). [17] Ionic brain edema can also occur around the sites of brain hemorrhages, infarcts, or contusions due to a local plasma osmolality pressure gradient when compared to the high osmolality in the affected tissue.
Serum ammonia levels are elevated in 90% of people, but not all hyperammonaemia (high ammonia levels in the blood) is associated with encephalopathy. [4] [9] A CT scan of the brain usually shows no abnormality except in stage IV encephalopathy, when brain swelling (cerebral oedema) may be visible. [9]
Hyperammonemia, or high ammonia levels, is a metabolic disturbance characterised by an excess of ammonia in the blood. Severe hyperammonemia is a dangerous condition that may lead to brain injury and death. It may be primary or secondary. Ammonia is a substance that contains nitrogen. It is a product of the catabolism of protein.
Patients presenting as acute and hyperacute liver failure are at greater risk of developing cerebral edema and grade IV encephalopathy. The pathogenesis remains unclear, but is likely to be a consequence of several phenomena. There is a buildup of toxic substances like ammonia, mercaptan, serotonin and tryptophan in the brain.
Hyperammonemia, elevated level of ammonia in blood (including cerebral edema/intracranial pressure) Guillain–Barré syndrome, due to elevated protein levels; POEMS syndrome, a paraneoplastic syndrome that can cause increased intracranial pressure. Foster Kennedy syndrome (FKS) Chiari malformation; Tumors of the frontal lobe
An increase in pressure, most commonly due to head injury leading to intracranial hematoma or cerebral edema, can crush brain tissue, shift brain structures, contribute to hydrocephalus, cause brain herniation, and restrict blood supply to the brain. [13] It is a cause of reflex bradycardia. [14]
Lee's death was officially ruled the result of cerebral edema — swelling of the brain. While a normal human brain is about 3 pounds, Lee's was reportedly closer to 3½ pounds.
[1] [6] Up to 1% of children with DKA develop a complication known as cerebral edema. [2] Rates of cerebral edema in US children with DKA have risen from 0.4% in 2002 to 0.7% in 2012. [44] Between 2 and 5 out of 10 children who develop brain swelling will die as a result. [10]