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Symptomatic cerebral edema (CE) in pediatric patients with DKA is uncommon and is defined by diagnostic criteria, including abnormal motor or verbal responses to pain, decorticate posture, and abnormal neurogenic respiratory patterns.
Fourth, data suggest that the predominant pathophysiology early after initial cerebral injury (broadly defined) is cerebral ischemia, followed in the subacute stages by a more vasogenic process. Finally, impaired cerebral autoregulation is documented in both TBI and DKA, either reflecting the disease severity or playing a role in the ...
cerebral edema, as detected by subtle brain computed tomography (CT) or magnetic resonance imaging (MRI) changes, can occur in as much of 50% of DKA patients. Hence, early identification of clinically relevant cerebral edema in DKA relies on clinical criteria rather than solely on radiological tests [5]. Clinical identification of
CLINICAL DIAGNOSIS. The classical clinical findings of CE are a combination of a decrease in level of consciousness, onset of headache, vomiting, incontinence, inappropriate slowing of HR and an inappropriate elevation of BP and papillary unevenness or un-reactivity.
Cerebral edema is a condition of excess of fluid in the brain resulting from either neurological or non-neurological causes. Cerebral edema can result from a variety of mechanisms. These include cellular, vasogenic, interstitial, and osmotic mechanisms.
pathophysiology of DKA-related cerebral edema through the use of diffusion and perfusion MRI. If cerebral edema during treatment were caused by osmotic shifts resulting in cellular swelling, we would anticipate that the ADC during DKA treatment would be decreased,14,19 and cerebral perfusion would be diminished or unchanged. PATIENTS AND METHODS
Objective: To review the causes of cerebral edema in diabetic ketoacidosis (CEDKA), including pathophysiology, risk factors, and proposed mechanisms, to review the diagnosis, treatment, and prognosis of CEDKA and the treatment of diabetic ketoacidosis as it pertains to prevention of cerebral edema. Data source: A MEDLINE search using OVID was ...
