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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.
External hydrocephalus is a condition generally seen in infants which involves enlarged fluid spaces or subarachnoid spaces around the outside of the brain. This condition is generally benign , and resolves spontaneously by two years of age [ 45 ] and therefore usually does not require insertion of a shunt.
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]
[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]
The thrombosis of the veins themselves causes venous infarction (damage to brain tissue due to a congested and therefore insufficient blood supply). This results in cerebral edema (both vasogenic and cytotoxic edema), and leads to small petechial haemorrhages that may merge into large haematomas. Thrombosis of the sinuses is the main mechanism ...
Malignant post traumatic cerebral swelling can develop unexpectedly in stable patients after an injury, as can post-traumatic seizures. Recovery in children with neurologic deficits will vary. Children with neurologic deficits who improve daily are more likely to recover, while those who are vegetative for months are less likely to improve.
In severe or acute hypoosmolar hyponatremia, swelling of brain cells causes various neurological abnormalities, which in severe or acute cases can result in convulsions, coma, and death. The symptoms of chronic syndrome of inappropriate antidiuresis are more vague, and may include cognitive impairment, gait abnormalities, or osteoporosis. [2]
The body (in particular the brain) adapts to the higher sodium concentration. Rapidly lowering the sodium concentration with free water, once this adaptation has occurred, causes water to flow into brain cells and causes them to swell. This can lead to cerebral edema, potentially resulting in seizures, permanent brain damage, or death.