Skip to main content
SpringerLink
Log in

Pathophysiological aspects of brain edema

  • Original Works
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Summary

Two mayor types of brain edema, related to two different pathomechanisms, can be recognized: 1)cytotoxic type-where the main feature is the swelling of cellular elements of brain parenchyma and 2)vasogenic type-where an increased vascular permeability leading to accumulation of edema fluid inthe extracellular spaces plays the principal role. In this type of edema, there is a close interrelationship between extravasation of serum proteins and retention of water in the brain tissue. In theischemic brain edema both cytotoxic and vasogenic mechanisms are involved. A biphasic opening of the blood-brain barrier, associated with vasogenic edema, is observed following release of major cerebral artery occlusion. The first opening of the barrier is related to a reactive hyperemia which follows promptly recirculation. The second opening, recognizable after a delay, is associated with a severe ischemic brain tissue injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aleu FP, Katzman R, Terry RD (1963) Fine structure and electrolyte analysis of cerebral edema induced by alkyltin intoxication. J Neuropathol Exp Neurol 22:403–414

    Google Scholar 

  2. Fujimoto T, Walker JT, Spatz M, Klatzo I (1976) Pathophysiologic aspects of ischemic edema. In: Pappius HM, Feindel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York, pp 171–180

    Google Scholar 

  3. Furuse M, Gouda T, Kuchiwaki H, Hirai N, Inao S, Kageyama N (1983) Termal analysis on the state of free and bound water in normal and edematous brain. In: Proceedings of the 5th International Symposium on Brain Edema, Groningen, 1982. Plenum, New York

    Google Scholar 

  4. Hirano A, Levine S, Zimmerman HM (1967) Experimental cyanide encephalopathy: Electron microscopic observations of early lesions in white matter. J Neuropathol Exp Neurol 27:571–580

    Google Scholar 

  5. Klatzo I (1967) Presidential address: Neuropathological aspects of brain edema. J Neuropathol Exp Neurol 26: 1–14

    Google Scholar 

  6. Klatzo I, Wisniewski H, Steinwall O, Klatzo I (1967) Dynamics of cold injury edema. In: Klatzo I, Seitelberger F (eds) Brain edema. Springer, Berlin Heidelberg New York, pp 554–563

    Google Scholar 

  7. Klatzo I, Chui E, Fujiwara K, Spatz M (1980) Resolution of vasogenic brain edema. Adv Neurol 28:359–374

    Google Scholar 

  8. Kuchiwaki H, Furuse M, Gouda T, Ikeyama A, Kageyama N (1983) Studies on changes in tissue water constitution and focal brain tissue pressure in experimental cerebral infarction. In: Proceedings of the 5th International Symposium on brain edema, Groningen 1982. Plenum, New York

    Google Scholar 

  9. Kuroiwa T, Cahn R, Juhler M, Goping G, Campbell G, Klatzo I (1985) Role of extracellular proteins in the dynamics of vasogenic brain edema. Acta Neuropathol (Berl) 66:3–11

    Google Scholar 

  10. Kuroiwa T, Ting P, Martinez H, Klatzo I (1985) The biphasic opening of the blood-brain barrier to proteins following temporary middle cerebral artery occlusion. Acta Neuropathol (Berl) 68:122–129

    Google Scholar 

  11. Raichle M, Hartman B, Eichling JO, Sharpe L, Grub RL (1976) Central noradrenergic regulation of brain microcirculation. In Pappius HM, Feindel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York, pp 11–16

    Google Scholar 

  12. Rasmussen LE, Klatzo I (1969) Protein and enzyme changes in cold injury edema. Acta Neuropathol (Berl) 13:12–28

    Google Scholar 

  13. Reulen HJ, Graham R, Fenske A, Tsuyumu M, Klatzo I (1976) The role of tissue pressure and bulk flow in the formation and resolution of cold-induced edema. In: Pappius HM, Feidel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York, pp 103–112

    Google Scholar 

  14. Suzuki R, Yamaguchi T, Kirino T, Orzi F, Klatzo I (1983) The effect of 5-minute ischemia in mongolian gerbils: Blood-brain barrier, cerebral blood flow, and local cerebral glucose changes. Acta Neuropathol (Berl) 60:207–216

    Google Scholar 

  15. Suzuki R, Nitsch C, Fujiwara K, Klatzo I (1984) Regional changes in cerebral blood flow and blood-brain barrier permeability during epileptiform seizures and in acute hypertension. J Cereb Blood Flow Metab 4:96–102

    Google Scholar 

  16. Vorbrodt AV, Lossinsky AS, Wisniewski HM, Suzuki R, Yamaguchi T, Masaoka H, Klatzo I (1985) Ultrastructural observations on the transvascular route of protein removal in vasogenic brain edema. Acta Neuropathol (Berl) 66:265–273

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratory of Neuropathology and Neuroanatomical Sciences, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, 20892, Bethesda, MD, USA

    Igor Klatzo

Authors
  1. Igor Klatzo
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Prof. F. Seitelberger on the occasion of his seventieth birthday

Rights and permissions

Reprints and permissions

About this article

Cite this article

Klatzo, I. Pathophysiological aspects of brain edema. Acta Neuropathol 72, 236–239 (1987). https://doi.org/10.1007/BF00691095

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00691095

Key words

Search

Navigation