O conhecimento dos mecanismos fisiopatológicos da lesão cerebral no traumatismo .. O edema cerebral vasogênico resulta de distúrbio na barreira. Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the. AJR Am J Roentgenol. Sep;(3):W doi: /AJR Cerebral edema. Ho ML(1), Rojas R, Eisenberg RL. Author information.

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Sequential activation of hypoxia-inducible factor 1 and specificity protein 1 is required for hypoxia-induced transcriptional stimulation of Abcc8. In the mid-to-late s, cerebral edema was beginning to be recognized as an entity distinct from acute hydrocephalus, which theretofore was believed to etiologically underlie all cases of excess intracranial water.

Perihematomal vasogenic edema, the second stage of perihematomal edema, occurs when extravasation of blood products triggers changes in brain endothelium that manifest as extravasation of serum proteins without extravasation of erythrocytes.

Glial-conditional deletion of aquaporin-4 Aqp4 reduces blood-brain water uptake and confers barrier function on perivascular astrocyte endfeet. Cellular influx of osmolites may occur due to primary active transport or secondary active transport. When tissue pressure exceeds capillary pressure, capillary lumens collapse, precipitating a feedforward process wherein ischemia of the surrounding shell triggers further edema formation and further swelling in the next shell.

Ohata K, Marmarou A. Unfortunately, without a greater understanding of how aquaporin-4 controls water edemma solute flux eddma the endfoot layer of the BBB, it is unclear how aquaporin-4 water transport might affect endothelial ion transport. Expression and cell distribution of group I and group II metabotropic glutamate receptor subtypes vazogenico taylor-type focal cortical dysplasia.

The pathophysiological mechanisms following traumatic brain injury

Vasogenic edema Vasogenic edema is a form of extracellular edema characterized by breakdown of the BBB, wherein a transendothelial permeability pore forms that permits extravasation of water and plasma proteins such as albumin and IgG into the brain interstitial compartment. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. While significant gaps still remain in our understanding of how specific proteins contribute to cerebral edema, the fields of cerebral edema and brain ISF dynamics are robust and productive.


Astrocyte swelling appears to be a general response of astrocytes to injury and occurs quickly following a variety of types of CNS injury, including ischemia, trauma, hypoglycemia, status epilepticus, and fulminant hepatic failure, though importantly, the mechanisms driving the swelling may differ among etiologies.

I Mecanismos de morte celular.

Cerebral edema – Wikipedia

Nat Rev Neurol ; Monocyte chemoattractant protein-1 and the blood-brain barrier. This results in trans-ependymal flow of CSF, causing CSF to penetrate the brain and spread to the extracellular spaces and the white matter. However, as the tissue is isolated from any possible source of new ions or water mass, the tissue will not become heavier and will not swell. Neurocrit Care ; Methemoglobin is an endogenous toll-like receptor 4 ligand-relevance to subarachnoid hemorrhage.

Secondly, a hemorrhage-specific phenomenon called clot retraction, where activation of the coagulation cascade in the hematoma results in exudation of serum proteins and increased colloidal pressure of the perihematomal space, drives influx of water.

Mechanisms of glial swelling induced by glutamate.

Cerebral edema.

The concept that only the osmotic forces influence ionic edema, while both osmotic and hydrostatic gradients influence vasogenic edema may help to explain the mixed outcomes that occur following decompressive craniectomy, a procedure that abruptly lowers intraparenchymal pressure. This property can be exploited to probe whether observed movements are due to diffusion or bulk flow.

Filtration and diffusion of water across the blood-brain barrier in man. Expression of mRNA from toad urinary bladder.

The cranial contents are divided into a series of fluid compartments, which are spaces separated by barriers that are relatively impermeable to water and are maintained at homeostatic volumes.


Die bedutun der symptomatischen hirnschwellung fur die hirntumoren und fur andere raumbeengende prozesse in der scadelgrube. Activation of the compliment cascade results in the production of anaphylatoxins, membrane attack complex MAC -mediated lysis of red blood cells and iron-induced edema, as well as infiltration of neutrophils.

Am J Physiol Cell Physiol ; Major routes for influx of ions and water in ionic edema.

A new look at ammonia. Astroglia and glutamate in physiology and pathology: Glutamate-dependent neuroglial calcium signaling differs between young and adult brain. J Hirnforsch ; Nitric oxide in traumatic brain injury.

Paravascular microcirculation facilitates rapid lipid transport and astrocyte signaling in the brain. Perihematomal ionic edema, the first stage of perihematomal edema, is driven by transendothelial osmotic forces generated by edma processes.

Subtypes of vasogenic edema include:. Primary drivers are substances that, through extrusion by primary active transport, are more concentrated outside of the cell than inside. Edit article Share article View cedebral history.

Glucose and lactate metabolism modulation by ascorbic acid. Larger molecules will diffuse more slowly than smaller molecules.

Cerebral edema

Oncotic death of endothelial cells mediated by Sur1-Trpm4 is likely an important factor in hemorrhagic transformation after a variety of CNS injuries. Physiol Rev ; While historical models have focused on the gross or ultrastructural appearance of edematous brain tissue, cerebral edema is better understood in a cellular and molecular context.

Teasdale G, Mathew P. Ischemic colitis small intestine: The role of hypoxia-inducible factor-1alpha, aquaporin-4, and matrix metalloproteinase-9 in blood-brain barrier disruption and brain edema after traumatic brain injury. Oxford University Press,pp. Arch Neurol ;