Hi everyone,

 

I know it sounds obvious. But in cerbral oedema lets say due to vasgenic cause,the problem is cerebral vessels becoming more permeable and leaking out blood to extravascular compartment. Now how does the brain get bigger due to this. I mean for brain to get bigger, the intracellular fluid volume of brain cells must increase. So when these capillaries leak blood out, do near by brain cells absorb these water, increasing their intracellular volume and as a result we get enlarged brain? or does this leaked out fluid get stuck in brain interstitium making it bigger. I hope u understand my confusion, because leaking out fluid must make brain smaller otherwise. Thanks

 

 

Hello ,

 

The brain Parenychima gets bigger and that manifests itself in brain herniation .

 

The brain herniation has several stages and the insults vary with each cause . Hypo-osmolarity is very crucial to treat .

 

In DKA , diabetic ketoacidosis , the insulin infusion is not started immediately but after an hour of fluids resuscitation because rapid implement of insulin therapy in these cases would cause fast drop in serum osmolarity and consequence brain edema .