Wet brain
Description:
Wet brain — the pathological process which is shown excess accumulation of liquid in cells of a head or spinal cord (first of all glias) and intercellular space, increase in volume of a brain and intracranial hypertensia.
Wet brain symptoms:
Clinical displays of hypostasis - brain swelling are identical regardless of its pathogenetic type.
They consist of a combination of three groups of symptoms: the caused syndrome of intracranial hypertensia, focal and trunk symptoms.
The syndrome of intracranial hypertensia arises owing to increase in the closed space of a head cavity of liquid and is shown by an arching headache, nausea, vomiting at pain height, decrease in level of consciousness. At it is long the existing intracranial hypertensia on roentgenograms of a skull it is possible to note strengthening of manual impressions, osteoporosis of a dorsum sellae, at an eyeground research - swelled nipples of optic nerves.
Localization of hypostasis in certain areas of a brain leads to disturbance of their work and according to loss of the functions presented by them - focal symptomatology.
Also hypostasis of one sites of a brain leads to shift them concerning others and to emergence of dislocation syndromes which are followed by a prelum of structures of vessels and a brainstem. Accession of trunk symptomatology in clinic is shown by disturbances of breath, a krovobrashcheniye, oppression of reaction of pupils and is zhizneugrozhayushchy.
Wet brain reasons:
On a pathogeny wet brain is divided on vazogenny, cytotoxic, intersticial and filtrational. Depending on an etiological factor, distinguish tumoral, traumatic, postoperative, toxic, inflammatory, ischemic and hypertensive swelled a brain.
In literature there is no consensus concerning the term "wet brain". So, in BME (1981) there is no article "wet brain" at all, and the phenomenon is described in the article "swelled also brain swelling". Swelled, on BME terminology, it is shown by expanding and squeezing by edematous liquid of cells that leads to disturbance of interstitial exchange and transport of oxygen with the subsequent dystrophy and cellular death. The term "swelling" is defined as "increase in volume of cells or a stroma of internals". Pure hypostasis or brain swelling practically does not meet. In modern scientific literature accumulation of liquid in brain cells owing to damage of cellular membranes and cytoplasm is more often designated as wet brain option — cytotoxic swelled.
Treatment of Wet brain:
One of the main objectives at treatment of the patient with intracranial pathology in the acute period is providing at it the normal level of the central perfused pressure (CPP) as it defines sufficiency of blood supply and intake of nutrients to neuron.
TsPD is determined by a formula:
TsPD = the average arterial pressure (AAP) – the intracranial pressure (VChD) – the central venous pressure (CVP).
Wet brain leads to development of intracranial hypertensia, i.e. increase in VChD and respectively to decrease in TsPD.
Treatment of hypostasis - brain swelling provides
* oxygenation maintenance (ro2> 70 mm. hg), if necessary – transfer into IVL
* elimination of motive excitement and spasms
* prevention and elimination of pain and nociceptive reactions
* elimination of the reasons breaking venous outflow from a head cavity
* maintenance of normal body temperature
* moderate hyperventilation
* purpose of diuretics
At inefficiency of conservative treatment operation a decompressive craniotrypesis, by removal of a bone rag for the purpose of decrease in VChD raised owing to wet brain is performed.
