Potential mechanisms and clinical significance of global cerebral edema following aneurysmal subarachnoid hemorrhage

Neurosurg Focus. 2007 May 15;22(5):E7. doi: 10.3171/foc.2007.22.5.8.

Abstract

In an attempt to elucidate the pathophysiology and clinical significance of global cerebral edema (GCE) following aneurysmal subarachnoid hemorrhage (SAH), the authors explored potential mechanisms and reviewed findings associated with this phenomenon. Admission computed tomography (CT) scans show GCE in up to 20% of patients experiencing aneurysmal SAH. This edema is likely to have been initiated by transient global ischemia, as indicated by an association between ictal loss of consciousness and the development of edema. A further cascade of events, including a rise in intracranial pressure and compromise of the blood-brain barrier, are also likely contributors. Clinically, GCE on CT after aneurysmal SAH is predictive of a poor outcome. Further investigation is needed to gain a full understanding of edema development following SAH, with the hope that the knowledge can be used to influence treatment positively and improve outcome.

Publication types

  • Review

MeSH terms

  • Blood-Brain Barrier / physiopathology
  • Brain Edema / etiology*
  • Disease Progression
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Pressure / physiology
  • Models, Biological
  • Subarachnoid Hemorrhage / complications*
  • Time Factors