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Edema
Etiology

May be due to tumor, trauma, infection, metabolic disease, vascular disease or toxins.
Pathogenesis

There are two types of edema - vasogenic and cytotoxic.
In vasogenic edema, seen in infection, vascular disease trauma and tumor, the blood brain barrier is defective and fluid enters the interstitial space.
In cytotoxic edema the Na-K pump breaks down as does Calcium transport so fluid enter the cells including neurons.
In both cases astrocytes swell.,
Epidemiology

See etiology.
General Gross Description

Edema causes brain swelling with flattening of gyri and narrowing of the sulci.
It can also cause subfalcial transtentorial and foramen magnum herniation with shift of the cingulate gyrus under the falx in asymmetrical swelling and uncal grooving and tonsillar hernation.
The brain generally has a congested appearance.
•Examples:
Cerebral Edema Cerebral Edema
General Microscopic Description

Microscopically edema is characterised by vacuolization or spongy change of the neuropil and pericellular vacuolization as well as pallor of the tissue and swollen astrocytes.
In cytoxic edema neurons and myelin sheaths may also be swollen.
•Examples:
Cerebral Edema Cerebral Edema
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1299-1300.
Greenfield's Neuropathology, 6th ed. Graham DI, Lantos PL (ed), New York: Arnold, 1997, pp. 166-173.

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Edema
Synopsis by: M.L. Grunnet M.D. (TX2000M36500)[400]
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