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17 Αυγ 2022 · Subclinical cerebral edema, as detected by ventricular narrowing on imaging studies or alterations in brain water distribution on magnetic resonance imaging (MRI), has been reported in the majority of children with DKA, even in the absence of neurologic signs or symptoms (image 1) [6,15,16].
This review critically examines the literature on the pathophysiology of CE and attempts to categorize the findings by types of brain injury that contribute to its development: cytotoxic, vasogenic, and osmotic.
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.
Cerebral edema (CE) is a potentially devastating complication of diabetic ketoacidosis (DKA) that almost exclusively occurs in children. Since its first description in 1936, numerous risk factors have been identified; however, there continues to be ...
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
Mechanism of Cerebral Edema in the Course of DKA. The pathophysiology of cerebral edema in the course of DKA is still debated and three potential etiologies are under scrutiny: 1) blood-brain barrier and vascular disturbances, 2) astrocyte edema and cytotoxic edema and 3) disturbances of cell membrane function [23-25]. The vascular cause ...
The study highlights that while head CT is obtained to diagnose cerebral edema, decisions about treatment of patients with DKA and suspected CE are not affected by head CT results and, in-fact, obtaining a head CT may have led to a significant delay in hyperosmolar therapy.
