What are the early symptoms of cerebral edema?

Cerebral edema is an increasingly common disease, posing a huge threat to people's health, because it may cause the patient to lose consciousness or directly endanger his or her life. Therefore, the prevention and treatment of cerebral edema is very necessary. However, diagnosing cerebral edema is relatively difficult, and most patients are in the middle or late stages when discovered, which seriously affects the treatment effect. Let’s take a look at the early symptoms of cerebral edema.

Cerebral edema refers to a pathological phenomenon in which the water content in the brain increases, leading to an increase in brain volume. It is the response of the brain tissue to various pathogenic factors. It can cause intracranial hypertension and damage brain tissue. It is common in clinical practice in neurological diseases such as craniocerebral trauma, intracranial infection (encephalitis, meningitis, etc.), cerebrovascular disease, intracranial space-occupying diseases (such as tumors), epileptic seizures, and systemic diseases such as toxic dysentery and severe pneumonia.

1. Headache

Increased intracranial pressure causes tension on the meninges, blood vessels, and cranial nerves, and inflammatory changes stimulate the nerves and cause headaches. It is paroxysmal at first and then develops into persistent, mainly in the forehead and bilateral temporal sides, with varying degrees of severity, often aggravated by coughing, sneezing, straining during bowel movements, bending over or standing up. When cerebral edema is severe, there may be a tearing sensation.

2. Projectile vomiting

Intracerebral hypertension stimulates the vomiting center at the bottom of the fourth ventricle and the medulla oblongata, causing projectile vomiting, rarely with nausea, unrelated to diet, and more severe in the early morning.

3. Head signs: bulging anterior fontanelle

Head signs such as bulging and tense anterior fontanelle, cracked sutures, increased head circumference, distended superficial veins of the head and face, and positive broken kettle sounds are subacute or chronic compensatory mechanisms, which are related to the fact that the sutures of the skull of infants and young children have not yet completely closed and the skull bones are soft and have a certain degree of elasticity. This compensatory mechanism often makes early symptoms atypical.

4. Impairment of consciousness

Intracranial hypertension causes extensive damage to the cerebral cortex and ascending reticular structure of the brainstem, causing children to experience varying degrees of impaired consciousness, agitation or mania. If cerebral edema cannot be controlled in time, the disorder of consciousness will rapidly worsen and the patient will enter a coma.

5. Increased blood pressure

When intracranial pressure increases, the compensatory pressor response of the vasomotor center in the medulla oblongata increases blood pressure. The systolic blood pressure can rise by more than 2.67 kPa (20 mmHg), and the pulse pressure widens and the blood pressure tone strengthens.