Cerebral Edema: Treatment, Procedure, Cost and Side Effects

Cerebral edema is a life threatening and dangerous condition which develops due to inflammatory reaction that affects the brain. Edema usually means swelling and cerebral edema is the swelling or inflammation of the brain. It results due to a lot of factors such as hypoxia, sepsis, allergy, tumour, abscess, haemorrhages, cerebral infarction, cerebral trauma and metabolic or toxic factors. During the treatment of cerebral edema it is important to monitor the patient’s condition in the ICU (intensive care unit). Positioning the patient’s head and tilting it around 30 degrees to optimize cerebral perfusion pressure is necessary. This also controls the rise in the intracranial pressure of the brain. Hyperventilation has to be applied because hypothermia can reduce the rate of metabolic activity in the brain. It is of utmost importance to maintain positive fluid balance inside the brain using crystalloid solutions.

The treatment for cerebral edema usually includes administrating barbiturates, NSAIDs (non steroidal anti-inflammatory drugs) and anti-hypertensive medications. Sometimes if the cerebral edema is quite serious and is in an advanced stage, it has to be treated by a surgical procedure called bilateral decompressive craniotomy. The treatment of cerebral edema is extremely complicated and positive results can only be produced if diagnosis and treatment is done as early as possible.

Inflammation in the brain can occur either throughout the brain or only on specific locations. Wherever, the swelling takes place, the ICP (intracranial pressure) increases inside the skull of the patient. This pressure prevents blood from travelling to the brain and in turn, deprives it of oxygen. The inflammation can block certain fluids from leaving the brain, this makes the inflammation worse. Cerebral edema is so devastating that it causes death or damage of the brain cells. Some infections can also result to cerebral edema such as meningitis, encephalitis, toxoplasmosis and subdural empyema. Apart from these, high altitudes and tumours can also result to cerebral edema.

At first, cerebral edema is diagnosed by neurologic exams, CT scan of the head, MRI of the head and blood tests. These tests are essential as it marks the location and cause of the swelling. There are a lot of treatments which help to get rid of this disease, one of them being hypothermia. This treatment involves lowering the body temperature and brain temperature. This helps the swelling of the brain and also allows it to heal properly. However, this treatment is extremely difficult to use because of its difficulty and complications.

Since hypothermia treatment is beneficial for the management of intracranial pressure, it is ideal for patients suffering from cerebral edema.

Sometimes inducing hypothermia in patients can also be risky as it can ruin the natural balance of your body and prove fatal for health. That is why it is important to consult a doctor before opting for a hypothermia treatment. Old people and young infants or teens should not opt for this treatment. People with dementia and other mental health disorders should also be cautioned against this treatment. Patients with certain medical ailments such as spinal cord injuries, Parkinson’s disease, trauma, severe arthritis, stroke, diabetes, anorexia nervosa and hypothyroidism should never consider hypothermia to cure cerebral edema.

Inducing hypothermia to combat cerebral edema can also have a lot of side effects such as, shivering, mumbling, shallow breathing, weak pulse, lack of coordination, memory loss, drowsiness, confusion, little or no consciousness and bright red skin in some people. However, these side effects only occur if this treatment is given more than it is required and if there is excessive hypothermia created by the doctors which can be very fatal for health.

After undergoing hypothermia to treat cerebral edema, one should take precaution and care to look after their health so that this doesn’t reoccur. Your head will be very sensitive for some days, so it is important to always wear a helmet while playing sports, skating or biking. Wear seat belts, try to control your blood pressure and blood sugar levels, avoid smoking and avoid travelling to high altitudes. It is also of utmost importance to go for monthly health checkups to keep yourself updated about your health.

After the hypothermia treatment, the patient is required to stay in the hospital for few days and his brain functions are monitored and studied by the doctor to see if the swelling has completely subsided or not. Only then, is the patient allowed a discharge from the hospital.

The price of this treatment in India is approximately, Rs. 6,800 to Rs. 9,000, excluding the hospital fees and the doctor’s consultation fees.

The results of this treatment is usually permanent but cerebral edema can occur again if proper care of the patient’s health isn’t taken. Once the swelling of the brain is controlled by inducing hypothermia, the brain gradually returns back to normal and the risk factor of brain damage no longer exists.

There are various treatments for cerebral edema other than hypothermia. This includes taking IV fluids, oxygen therapy, ventriculostomy and surgery. Surgical procedures include decompressive craniectomy or repairing the damaged vein or artery.