Brain swelling after alcohol. Brain swelling from alcohol

Cerebral edema is the most dangerous complication of any intracranial pathology, consisting in diffuse saturation of brain tissue with fluid from the vascular space.

Regardless of the root cause and localization of the disease, we talk about cerebral edema only when there are general symptoms that indicate the involvement of the entire brain in the pathological process, and not just its individual parts.

It is not for nothing that such changes are classified as severe complications, because they pose an immediate threat to life.

Cerebral edema is characterized by the accumulation of fluid in brain cells and their spaces. This pathology is especially dangerous for health, since in people, especially alcoholics, even a slight disruption of the functioning of this organ causes a number of unpleasant consequences.

The accumulation of fluids in the brain cavity leads to its rapid enlargement and also causes intracranial pressure. This condition leads to a significant deterioration in the general condition, so the patient requires urgent and qualified treatment.

It happens that cerebral edema occurs as a result of the accumulation of fluid not in the tissues, but in the brain cells. This most often happens with excessive drinking of alcohol, which interferes with the removal of fluid from the body.

Since the brain is constantly in a "closed state", it should not expand, since the bones of the skull are not able to expand. And when swelling appears in this organ, it has to “swell,” which leads to severe compression of the brain.

Important: cerebral edema causes a very dangerous condition, during which its work is aggravated, and the functionality of the entire cranium is impaired.

Doctors say that this disease overtakes drunkards after 1-3 months of constant drinking (often cerebral edema manifests itself much earlier, which depends on the general condition of the person).

Cerebral edema is a serious pathology associated with excessive accumulation of fluid in cells and intercellular space. The accumulation of fluid leads to enlargement of the brain and increased intracranial pressure.

Tissue swelling is a completely natural process, but not in the case when cerebral edema occurs. The brain is in a closed space, so it should not increase in volume.

The skull cannot expand under the influence of increased contents, which leads to compression of the brain. It is this condition that is dangerous - neuronal ischemia worsens and swelling spreads.

An increase in brain volume in a confined space reduces brain function and disrupts metabolic processes.

Cerebral edema is a pathology accompanied by excessive accumulation of fluid in the cells and tissues of the brain. There are many reasons for the development of this disease. Physical dependence on alcoholic beverages is also one of them, because with alcoholism there is a significant increase in the permeability of the walls of blood vessels.

The essence of the accepted definition of this condition is a nonspecific reaction of the whole organism in response to the influence of severe damaging factors. The latter are the reason:

disorders of blood microcirculation in brain tissue;
lack of oxygen transport to the brain, especially in combination with excess accumulation in the blood carbon dioxide;
disturbances of water-electrolyte, protein and energy metabolism with accumulation of lactic acid in nerve cells;
disorders of the acid-base state of the blood;
changes in osmotic (electrolyte) and oncotic (protein) pressure of plasma.

All these reasons lead to swelling and swelling of the brain. With edema, the permeability of the capillary walls is impaired and the liquid part of the blood leaks into the surrounding tissues.

During swelling, due to the difference in oncotic pressure, water molecules enter directly into the nerve cells of the brain through their membrane. Here they are bound by intracellular proteins and the cells increase in volume.

However, most authors of scientific articles consider swelling as one of the stages of edema, leading to a volumetric increase in the brain. This leads to its compression and displacement (dislocation) around its axis inside a closed space limited by the bones of the skull.

The spread of cerebral edema causes compression of the underlying structures (medulla oblongata) in the foramen magnum. It contains vital centers - regulation of breathing, cardiovascular activity and a thermoregulation center.

Signs of cerebral edema are clinically manifested in disruption of the functioning of nerve cells and brain centers even before complete damage to their structures occurs, which can already be determined using modern research methods.

Etiology and pathogenesis of alcoholic psychoses

Long-term and constant consumption of alcohol-containing drinks leads to the development alcohol addiction or alcoholism. Unlike ordinary everyday drunkenness, alcoholism is characterized by the formation of a persistent craving for alcohol in the alcoholic.

Chronic alcoholism over time leads to irreversible changes in the organs and systems of the human body. The biochemistry of metabolic processes, disturbances in the immune system, and pathologies develop, ultimately leading to death.

Biochemical disturbances and shifts ultimately lead to severe organic damage to organs and systems, such as:

Brain.
Heart and cardiovascular system.
The immune system.
Endocrine system.
Liver.
genitourinary system.

Damage to the body and its systems varies in severity. There are many factors at play here. Doctors tend to put this in dependence on heredity, as well as the individual characteristics of the body as a whole.

First of all, the blood suffers from the effects of alcohol: its biochemical composition, structure and course of metabolic processes are disrupted. In particular, the composition of protein fractions in the blood serum changes qualitatively, the process of formation of DNA cells occurring in lymphocytes, and the water-salt balance is disturbed.

During the oxidation of alcohol in the body (mainly when processing it in the liver), a large number of a substance such as acetic acetaldehyde, which in turn interacts with biogenic amines.

The destructive effect of this substance on the human brain has been proven, causing irreparable changes in all processes, from bioelectrical activity to an increase in the synthesis of catecholamines, an increase in the concentration of dopamine in brain tissue and blood.

Scientists believe that changes in metabolism in the brain lead to the development of severe mental disorders. The liver also suffers from the toxic effects of alcohol (cirrhosis develops), degenerative changes appear in the myocardium, and nephropathy may develop.

Severe disorders of the liver, kidneys, and changes in the brain due to alcohol intoxication lead over time to the development of mental disorders and personality disorders of the patient. The situation is also aggravated by a history of head injuries - this greatly increases the likelihood of alcoholic psychosis.

Causes of GM swelling

Causes of swelling of the brain or spinal cord include:

head injuries that affect the cranial bone (the process can be triggered by either a minor injury or a serious accident);
intracranial hemorrhage;
infectious pathologies;
viral infections that provoke inflammatory processes;
purulent tumors that are located inside the meninges;
sudden changes in altitude;
pathologies that can block the supply of oxygen;
cancerous tumors;
alcoholism.

Normally, intracranial pressure (ICP) in adults is between 3 and 15 mm. rt.

Art. In certain situations, the pressure inside the skull begins to rise and create conditions unsuitable for the normal functioning of the central nervous system (CNS).

A short-term increase in ICP, which is possible with coughing, sneezing, heavy lifting, or increased intra-abdominal pressure, as a rule, does not have time to have a detrimental effect on the brain in such a short period of time, and therefore cannot cause cerebral edema.

Depending on the reasons for the accumulation of fluid in the brain tissue, one or another type of edema is formed.

The most common form of brain swelling is vasogenic. It comes from a disorder of the functionality of the blood-brain barrier.

This type is formed due to an increase in the size of the white matter - with TBI, such edema is already able to make itself known before the end of the first day. Favorite places for fluid accumulation are nervous tissues surrounding tumors, areas of operations and inflammatory processes, areas of ischemia, and areas of injury.

Such swelling can quickly turn into compression of the brain.

The most common factors that provoke this complication are:

acute circulatory disorders (stroke);
surgical interventions;
severe intoxication, including alcohol poisoning;
anaphylactic reactions due to allergies.

There are also less common reasons that explain why cerebral edema occurs:

cancer tumors and metastases;
fractures of the bones of the cranial vault and base;
decompensated renal, hepatic, heart failure;
meningitis;
brain contusion;
post-traumatic intracranial hematomas;
diffuse axonal damage;
meningoencephalitis;
toxoplasmosis;
subdural empyema.

Brain swelling after stroke

Since the brain is a tissue with increased blood supply, it is quite easy to cause microcirculatory disorders that lead to cerebral edema.

The probability of this is greater, the more extensive the focus of the primary lesion, which may be:

Cerebral circulation disorders in the form of ischemic or hemorrhagic strokes;

Hemorrhages in the ventricles and brain tissue;

Cancerous tumors of intracranial localization (glioblastoma, meningioma, astrocytoma);

Brain metastases from malignant tumors of any location;

Fractures of the cranial vault with brain damage;

Meningitis and meningoencephalitis;

Fracture of the base of the skull;

Intracranial post-traumatic hematomas;

Diffuse axonal damage and brain contusion;

Severe intoxication and poisoning (alcohol, toxic compounds and chemicals, neuroparalytic poisons);

Decompensated hepatic-renal failure;

Any surgical interventions on brain tissue;

Anasarca due to heart failure, anaphylactic reactions of the allergic type.

As can be seen from this list of reasons, not only intracranial factors can provoke cerebral edema. Sometimes this formidable complication becomes a consequence of general changes in the body that occur in the microvasculature of all organs and tissues and are caused by external and internal pathogenic factors.

But if swelling of other organs very rarely leads to serious consequences, then cerebral edema almost always ends sadly.

It is very difficult to clearly indicate where the line is and why the transition from local swelling in the lesion to general cerebral edema occurs. It all depends on many factors, which may include age, gender, concomitant diseases, localization and size of the primary pathological process in the brain.

In some cases, even minor injuries can cause fulminant cerebral edema, while at the same time, even massive destruction of parts of the brain is sometimes limited to transient or transient edema.

Collapse

Alcohol is an unconditional evil that mercilessly and persistently harms the health and well-being of people. Strongly drinking people expose their body to destruction.

All organs without exception suffer from alcohol intoxication; the cardiovascular system is subjected to severe attacks. The mind and soul of a person becomes a victim of intoxicating drinks.

The central nervous system experiences the strongest pressure.

Brain edema due to alcoholism can lead to serious complications that are detrimental to health.

Researchers claim that alcohol enters the brain a few seconds after consumption, however, everyone can confirm this statement from their own experience. Within minutes, changes begin to occur at the micro level.

Brain cells absorb the sugar contained in alcohol instead of their usual treat - glucose. The brain absorbs destructive energy from alcoholic drinks.

Systematic intake of intoxicating drinks over a long period of time lays the foundation for the gradual destruction of the brain.

At the very beginning of the process of alcohol abuse, neurons die, which leads to a decrease in brain volume and the formation of microtraumas and ulcers.

When drinking alcohol regularly, fluid accumulates in the brain as a result of alcohol poisoning.

Brain swelling can occur in both adults and children. The fact is that the reasons for the development of such a condition are extremely diverse. If cerebral edema develops, the causes may be rooted in the following diseases and disorders:

traumatic brain injuries;
anaphylactic shock;
stroke;
cerebral hemorrhages of any etiology;
infectious diseases;
pathologies of the cardiovascular system;
burn disease;
oxygen starvation;
birth injuries;
severe intoxication;
tumors;
changes in atmospheric pressure.

The reasons for the development of such a condition as cerebral edema can vary significantly in different age groups. Common infectious causes of cerebral edema in different age groups include:

meningitis;
encephalitis;
toxoplasmosis:
subdural abscess.

Usually in newborn children, the cause of the appearance of this condition lies in birth injuries and congenital disorders of tissue structure.

With existing congenital disorders of the outflow of cerebrospinal fluid, the development of such a severe pathological condition as hydrocephalus often occurs.

The thing is that against the background of all these pathological conditions, certain areas of the brain die off due to hemorrhage or tissue ischemia caused by insufficient blood supply.

In young people, the reasons for the development of cerebral edema often lie in various injuries received at work, in domestic conditions, and in car accidents.

In addition, alcohol and drug intoxication are common causes of edema in this category.

The appearance of a tumor often causes swelling due to the fact that the growing malignant formation puts pressure on healthy tissue.

Brain swelling due to changes in atmospheric pressure is often extremely minor and is most often observed in people who dive to great depths, and also in climbers.

95-year-old father Georgy: “Don’t take blood pressure pills! It’s better to make a decoction of..."

Cerebral edema can occur in different scenarios, each of which has its own characteristics, causes and consequences. Currently, there are 4 main types of cerebral edema, including:

vasogenic;
cytotoxic;
gyrostatic;
osmotic.

Vasogenic edema usually develops due to a pathological increase in the permeability of the walls of blood vessels in the brain. In the vast majority of cases, this type of cerebral edema is observed with hemorrhages of various etiologies and tumor growths.

Cytotoxic edema is usually a consequence of poisoning of brain tissue.

This type of swelling, with proper first aid, may not have any irreparable consequences, but the necessary medical assistance should be provided no later than 6-8 hours later.

In the absence of targeted treatment, after the specified time, a critical change in the metabolism of brain tissue is observed, which leads to their death.

Hydrostatic edema occurs in cases where a person has a critical increase in ventricular pressure.

Typically, this type of cerebral edema is observed in newborns.

In adults, this type of edema is rare and in most cases is a consequence of surgery or traumatic brain injury.

The osmotic type of cerebral edema can be observed in both adults and children. Typically, this variant of the course of the disease occurs when the normal ratio of plasma and tissue of the brain itself is violated.

This type of edema is in the vast majority of cases the result infectious diseases, renal failure and improper hemodialysis, and in addition, hyperglycemia.

A separate group includes edema in newborns, which can develop as a result of disturbances in the intrauterine development of brain structures, birth injuries and fetal hypoxia.

Cerebral edema is a pathology in which the circulation of fluid inside the skull is impaired, which can lead to severe pressure on the tissue and cell death. If the disorder is detected at the wrong time or without proper therapy, the patient may die.

Not only processes occurring in the intracranial space, but also changes in the body that affect microcirculation can provoke cerebral edema. Swelling of the tissues of other organs leads to complications in rare cases; cerebral edema in most cases has a disappointing prognosis.

Causes of cerebral edema:

ischemic or hemorrhagic stroke;
cerebral hemorrhages;
cancer of the intracranial space (glioblastoma, astrocytoma, meningioma);
metastases;
fracture of the vault or base of the skull with brain damage;
meningoencephalitis and meningitis;
hematoma formation due to intracranial damage;
brain damage and contusion due to mild concussions;
renal and liver failure with disruption of the normal functioning of these organs;
brain surgery;
swelling due to heart failure;
anaphylactic shock;
intoxication (alcohol, toxic compounds and poisons).

Sometimes it is very difficult to determine what causes cerebral edema. Local swelling of tissues turns into general edema under the influence of many factors - the patient’s age, gender, concomitant diseases, localization of pathological processes.

Clinical picture

typical body type with thin limbs and a large belly;

swelling of the face;

dry skin with bruises and peeling.

stubborn headache, which cannot be treated with painkillers;

nausea turning into vomiting;

gradual loss of consciousness;

development of seizures.

isotope scanning;

CT scan.

Consequences of cerebral edema in adults and children

The sooner such a pathology is detected and intensive and adequate medical care is provided, the higher the chances of recovery. In a hospital setting, the blood supply to the brain, cerebrospinal fluid dynamics, and dehydration therapy are restored; the prognosis is largely determined by the severity of the disease.

Because with minor perifocal edema, complete recovery is possible, but with the development of cystic-atrophic processes in the brain tissue, only partial restoration of functions can be achieved.

When only the underlying disease, accompanied by cerebral edema, is treated, recovery is not possible in all cases and the risk of death is high.

Signs of a brain tumor

Swelling of the brain occurs suddenly. Its signs:

Pain in the head.
Vomit.
Frequent nausea.
Breathing disorders.
Dizziness.
Visual impairment.
Cramps, sometimes severe.
Speech difficulties.
Loss of consciousness.
Decreased consciousness – stupor.
Partial paralysis of the body.
Pupil dilation.
Slow heart rate.
Drowsiness.

These symptoms manifest differently in each person. This depends on the stage of the disease and the characteristics of the body. Diagnosis of brain disease is carried out by electroencephalography, echoencephalography, pneumoencephalography and other methods.

Pain in the head.
Pain in the cervical region, numbness of the skin.
Vomit.
Frequent nausea.
Breathing disorders.
Dizziness.
Visual impairment.
Memory loss (partial or complete).
Impaired balance and gait (ataxia).
Cramps, sometimes severe.
Speech difficulties.
Loss of consciousness.
Decreased consciousness – stupor.
Intracranial pressure is increased.
Partial paralysis of the body.
Some fundus changes.
Pupil dilation.
Slow heart rate.
Drowsiness.

Alcoholic delirium (delirium tremens) is an acute psychosis with severe, often irreversible damage to the nervous system.

Delirium tremens can be fatal in a significant number (more than 10%) of cases. Irreversible changes in the psyche are possible, leading to loss of ability to work.

Recovery of the nervous system after a severe stage of alcoholism can take several years. In some cases, it seems that the patient has emerged from the state of psychosis without visible changes.

Unfortunately, it is not. Any acute psychosis causes irreparable damage to health.

Symptoms

The clinical manifestations of edema, regardless of its pathogenetic characteristics, are always identical. There are only 3 symptoms:

focal;
stem;
intracranial hypertension syndrome.

Intracranial hypertension syndrome develops due to an increase in the level of fluid in the closed space of the skull. The person experiences uncontrollable nausea/vomiting, a bursting headache and a decreased level of consciousness.

Interesting: doctors note that in patients who have not sought help for ICH for a long time, strong digital impressions, swelling of the optic nipples and osteoporosis of the dorsum sella (part of the sphenoid bone of the skull) are visible on x-rays.

The swelling can be located in different parts of the brain, which leads to focal symptoms. It is impossible to predict which part of the brain will be damaged. Edema literally shuts down various functions controlled by the brain and limits a person's functionality.

Damage to certain areas of the brain can cause them to become displaced. This is fraught with dislocation syndromes, compression of blood vessels and the brain stem. The shift provokes the development of brainstem symptoms: suppression of pupillary response, impaired circulation and breathing. Stem symptoms are considered the most dangerous and can lead to death.

To establish edema, it is necessary to undergo a clinical examination. In modern medical practice they use:

electroencephalography (records the electrical activity of the brain);
angiography (examines the functionality of blood vessels using x-rays);
isotope scanning (gives a complete picture of the brain and damaged areas);
pneumoencephalography (examines the ventricles of the brain);
computed tomography.

The clinical picture of the described pathology is always identical and does not depend either on its causes or on the mechanisms of development. There are 3 groups of signs that characterize cerebral edema - symptoms are divided into the following types:

Intracranial hypertension syndrome. Due to tissue swelling, their volume increases significantly. Excess fluid in the skull leads to a strong increase in pressure. This provokes nausea, bursting and unbearable headache, and uncontrollable vomiting. If cerebral edema continues for a long time, deterioration of consciousness is observed.
Focal clinical manifestations. Swelling of tissues in certain parts of the control organ of the central nervous system causes a violation of their specific functions. As a result, paralysis, visual and speech disorders, and deterioration in coordination of movements are noted. Sometimes the patient is completely unable to carry out higher nervous activity and remains in an unconscious state.
Stem characteristics. Edema-swelling of the brain can lead to displacement of some organ structures, compression of nearby nerve endings and blood vessels by increased tissue volumes. Against the background of such phenomena, disturbances in cardiac and respiratory activity, deterioration of blood circulation, suppression of pupillary response and other life-threatening pathologies are observed.

The clinical picture of cerebral edema consists of general cerebral and focal symptoms. Their alternation and the sequence of joining to each other depend on the root cause of cerebral edema.

In this regard, fulminant and gradual forms of the disease can be distinguished. In the second case, there is at least some time to prevent further progression of suspected cerebral edema, and in the first, all that remains is to fight for the patient’s life and, if possible, slow down the progression of the pathological process.

Symptoms of cerebral edema may include:

Confusion of consciousness. This symptom always occurs. Its severity can vary: from stoppage to deep cerebral coma. The progression of cerebral edema is accompanied by an increase in fainting and its depth;

Headache . Only those whose cause of cerebral edema are chronic or dynamically increasing acute diseases of the brain can complain about it, provided they maintain consciousness;

Positive meningeal symptoms. Their appearance should be especially alarming against the background of aggravation of the patient’s general condition and disorders of consciousness;

Focal symptoms of brain damage. They can be recorded only at the stage of the appearance of edema in the form of impaired movement of the limbs or paralysis of half the body, speech and visual disorders, hallucinations, and manifestations of impaired coordination of movements. But classic cerebral edema is different in that all these functions are not possible at all. The patient, being in an unconscious state, is not capable of any elements of higher nervous activity;

Convulsive syndrome. Very often, as cerebral edema progresses, short-term convulsions appear, which are then replaced by complete muscle atony;

Drop in blood pressure and pulse instability. Very ominous symptoms of cerebral edema, indicating its spread to the brain stem, in which the most important nerve centers for the life support of the body are located;

Paroxysmal types of breathing. Like cardiac disorders, they reflect damage to important structures of the brain stem, in particular the respiratory center;

Signs of separation of the cerebral cortex from the subcortical centers (floating eyeballs, divergent strabismus).

Cerebral edema is a critical condition! Most of its cases are characterized by a progressive deterioration in the general condition of the patients, an increase in the depth of impairment of consciousness, and the loss of all abilities of higher nervous activity and motor activity!

The reasons why cerebral edema develops and its consequences can be very different. But many people create this problem on their own, because this pathology also manifests itself in alcoholism. The symptoms, at first glance, do not foretell anything special, but the consequences can be disastrous and everything can end in death.

A person provokes the manifestation of many diseases with his own hands, especially for those who drink alcohol too often, and whose passion for alcohol has developed into addiction. Among these diseases there is also cerebral edema, which accompanies the accumulation of secretions in large volumes in the cells of the head and other tissues of the human body.

Brain edema is accompanied by the following symptoms:

general weakness, malaise, increased drowsiness;
severe headaches, fainting and dizziness;
nausea and vomiting;
possible disturbance of vision and orientation in space;
difficulty breathing, impaired speech and memory;
muscle spasms.

A diagnosis such as cerebral edema is made with severe alcohol intoxication, the cause of which is considered to be a large amount of ethanol in the bloodstream.

The diagnosis of cerebral edema is made to people with severe alcohol intoxication. The cause of edema is high permeability of blood vessels due to the use of ethyl alcohol.

Symptoms of edema due to alcohol poisoning are similar to general symptoms.

Toxic edema can be identified when the patient exhibits the following signs during appearance:

normal build with a large belly and thin limbs;
puffy face;
the skin is covered with hematomas and peels off.

Brain edema in alcoholism is accompanied by the following symptoms:

severe persistent headaches;
pain in the cervical region;
numbness of the skin;
labored breathing;
memory loss;
loss of consciousness;
severe cramps;
nausea, vomiting;
increased blood and intracranial pressure;
slow heart rate;
drowsy state;
changes in the fundus, and sometimes decreased vision or blindness;
persistent feeling of anxiety;
in some cases, coma occurs;
with focal brain damage, the patient exhibits signs of impaired coordination, paralysis of a body part, speech disorders, and hallucinations.

Increased permeability of the walls of the head vessels leads to fluid retention. It accumulates, intracranial pressure increases, blood circulation in the brain is disrupted, which provokes many disorders.

The main symptoms of brain swelling:

severe headache, dizziness;
nausea and vomiting;
loss of consciousness;
hallucinations;
impaired memory, vision, slurred speech;
epileptic seizures;
weakness, drowsiness;
labored breathing.

Externally, toxic edema can be noticed by the puffiness of the face, pallor and dryness of the skin. The patient loses weight, the limbs are thin, and the stomach is large and distended. Bruises and hematomas of red and bluish color appear on the skin.

Sometimes even small concentrations of alcohol cause a severe allergic reaction. In this case, the edema develops rapidly, accompanied by loss of consciousness or coma. Drinking 0.5 liters of 90% alcohol, even for a healthy person, can be a lethal dose.

Brain edema caused by alcoholism develops suddenly and is characterized by the following symptoms:

Constant headaches;
Numbness of the skin and severe pain in the cervical region;
Frequent vomiting;
Nausea;
Uneven breathing;
Dizziness;
Visual impairment;
Complete or partial memory loss;
Ataxia – disturbance of gait and balance;
Severe cramps;
Difficulty speaking;
Loss of consciousness;
Stupor – decreased level of consciousness;
Increased intracranial pressure;
Minor paralysis of the body;
Slight change in the fundus;
Dilated pupils;
Rare pulse;
Drowsiness.

Signs of increased intracranial pressure

Delirium tremens is one of the most common mental disorders that people suffering from alcohol addiction can experience. At risk are people who regularly drink alcohol over 40 years of age, this also applies to those who have been on a binge for several days or more.

Diagnosis of the disease

It is currently possible to recognize the disease and make a diagnosis of cerebral edema in the initial stages. The following will help diagnose the disease and determine treatment methods:

echoencephalography - examination of the head using ultrasound echography, which is based on sending ultrasonic pulses deep into the brain, since they are reflected from the brain matter and form an image of the brain structure on the screen;
electroencephalography - a graphic reflection of the electrical activity of the brain; the recorded electroencephalogram is used to determine the location and size of the damage.
computed tomography is a method of computer data processing that is based on the attenuation of x-ray radiation when passing through tissues of different densities.
magnetic resonance imaging - with this research method, electromagnetic signals of atomic nuclei in a magnetic field are measured, the responses are processed by a computer and displayed as images on the screen.

Diagnosis of edema involves the following studies:

X-ray examination.
Brain scanning using radioactive isotopes.
ECHO-EG.

In an outpatient setting, diagnosing cerebral edema is quite difficult, since this condition does not have any special, specific neurological symptoms. In the early stages, cerebral edema may be mild or asymptomatic.

The diagnosis is made based on the symptoms of the underlying disease or injury that caused the swelling, as well as the results of a fundus examination.

If the development of cerebral edema is suspected, the patient should be taken to the intensive care unit or neurosurgical department. In a hospital setting, the issue of performing a lumbar puncture and angiography is decided. MRI and CT are informative, which help to identify edema, assess the degree of its severity and prevalence.

Treatment

For cerebral edema, regardless of the cause, immediate medical attention is needed. Why is swelling dangerous?

1. General and focal structural changes:

deformation of departments;
displacement of the skull to the occipital region and compression of the cerebellum;
compression of the brain stem.

2. Partial or complete damage to the cerebral cortex.

3. Many capillary ruptures with extensive hemorrhage.

The first and main task of doctors is to relieve swelling of the brain, thereby preventing damage to its main and stem parts. This will be enough to gain time and begin intensive therapy.

In critical cases, treatment may begin with the necessary surgical intervention:

removal of part of the bone plate of the skull;
installation of catheters for pumping out fluid.

Intravenous infusions help restore blood circulation.

It is very important to establish what caused the functional disorder. The medical approach provides for a fundamental difference in the treatment of edema caused by a tumor and, for example, alcohol intoxication.

Medicine has a large arsenal of tools to obtain the most accurate diagnosis. Along with the measures taken to relieve cerebral edema, therapeutic measures are taken to eliminate the cause itself.

In each individual case, drug treatment has a narrow focus, taking into account the degree of development of the disease causing edema and the general condition of the patient.

It is impossible to cure cerebral edema at home. If signs of this disease appear, you should consult a doctor. Only a qualified specialist can make an accurate diagnosis and prescribe treatment. Delay often leads to death.

At best, a person remains disabled forever. Modern medicine can cure cerebral edema completely and relatively quickly. To treat brain pathology in alcoholism, various combinations of surgical methods and medications are used:

Oxygen therapy is a very effective procedure. Through an inhaler, as well as with the help of other devices, a person breathes oxygen. This method enriches the blood with oxygen, and in this enriched form it enters the vessels of the brain.
Intravenous infusion of drugs helps maintain normal blood pressure and blood flow in general, and helps the body fight infections.
Ventriculostomy is an operation during which cerebrospinal fluid is sucked out of the brain and its ventricles. As a result, intracranial pressure decreases and the process of brain swelling stops.
Hypothermia is the process of artificially lowering body temperature. The procedure is relatively new and not yet widely used. It significantly reduces the size of the brain tumor.
Your doctor may prescribe medications to relieve swelling. They can be tablets and injections. But they will bring benefits only after recovery from alcoholism, since drunkenness and treatment of this disease are incompatible.
Barbiturates help reduce swelling and reduce cramps.
Drugs from the group of corticosteroids help restore blood flow in the area of edema.

Many other drugs are used for treatment. As a last resort, surgical intervention is used, as a result of which you can:

restore blood vessels damaged by the disease;
remove tumors;
remove some fragments of the cranial bone to reduce intracranial pressure.

Typically, swelling of the brain develops very quickly, but goes away quite quickly with timely medical care. She should be contacted immediately after symptoms of the disease are noticed. This disease can occur as a result of head injuries, infectious diseases and other reasons.

The primary goal of therapy is to ensure normal CPP (cerebral perfusion pressure). This is an indicator that characterizes the level of blood supply to the brain. It is the CPP that determines the level of supply of nutrients to the neuron and, accordingly, the quality of brain function.

Therapy includes:

providing the patient with free access to oxygen, if necessary, transferring to artificial ventilation;
neutralization of seizures or motor agitation;
elimination of pain, nociception (activity in the sensory fibers of the nervous system) and prevention of their possible development;
maintaining a safe body temperature;
eliminating the causes that disrupt the venous outflow from the closed cranial cavity;
moderate hyperventilation;
the use of medications that stimulate the outflow of fluids from the brain/spinal cord.

If conservative treatment is ineffective, doctors perform surgery - decompressive craniotomy. The specialist removes a bone flap to relieve high blood pressure and minimize swelling.

Prevention

Swelling can only be prevented in some cases. For example, a person cannot control the development of an intracranial brain tumor on his own, but abstaining from a drink or refusing to climb without preparation is quite possible. There are several recommendations from doctors that will help reduce the likelihood of brain swelling.

The first one is to control your blood pressure. Measure your own level and compare it with the normal level. If you see a discrepancy, consult a doctor, study your body and find out the recommendations for your specific case.

The second recommendation looks quite standard - stick to a healthy lifestyle. You should give up or minimize the consumption of alcoholic beverages, but it is better to permanently exclude drugs or smoking from your life.

It is impossible to cure brain pathology on your own at home. If the first causes and symptoms of this disease begin to manifest themselves, then you should seek qualified help from specialists, since only proper treatment can protect a person from death and dire consequences will not occur.

An illness that is not cured in time, at best, can turn an able-bodied person into a disabled person for the rest of his life. Modern medications, diagnostic methods and the growth of medical development can completely cure cerebral edema in a short time.

To treat the disease of alcoholism, many surgical and medicinal manipulations are performed:

Various medications may be used in the treatment process, but there are reasons why surgery is simply necessary. After they are completed, you can:

Renew blood vessels that have been damaged due to disease.
Remove the tumor.
Remove bone particles to reduce pressure and swelling.

The pathology develops rapidly, but also quickly passes if qualified assistance is provided in a timely manner. It is recommended to go to the doctor as soon as the initial signs are noticed in order to avoid adverse consequences.

Additionally, alcohol dependence is treated, since if the patient does not stop drinking alcohol, all other methods will not bring the desired effect. Brain edema is relieved with drugs that are introduced into the body in the form of solutions and tablets, including:

Dexamethasone;
Mannitol;
Furosemide.

And only in tablet form:

Metipred;
Prednisolone;
Eufillin;
CO-Trimoxazole-Acree;
Betaspan;
Tromethanol-N.

You can overcome alcohol addiction by undergoing treatment with the following drugs:

Teturam.
Esperal;
Disulfiram;
Proprothene-100;

A mild degree of the disease, for example, after a concussion or minor bruise, does not require special therapy. Such types of tissue swelling go away on their own within 2-4 days.

Hospitalization is necessary if severe cerebral edema progresses - treatment of complex and dangerous types of pathology is carried out only in the intensive care unit.

The main goal of therapy is to normalize cerebral perfusion pressure (CPP). It is responsible for blood supply, oxygen and nutrients to neurons. CPP is the difference between mean arterial pressure and the sum of intracranial and central venous pressure. Other treatment goals:

elimination of convulsions and motor overexcitation;
maintaining normal body temperature;
restoration of lung and heart functions;
normalization of the activity of damaged parts of the brain;
removal of causes that impede the outflow of venous blood from the cranial cavity;
relief and prevention of pain;
removing excess fluid from tissues.

Cerebral edema - emergency care

Patients with this severe diagnosis should be immediately hospitalized.

The diagnosis of cerebral edema, regardless of its origin, implies hospitalization of the patient exclusively in the intensive care unit. This is due to the presence of an immediate threat to life and the need to artificially maintain basic vital functions in the form of breathing and blood circulation, which is only possible with the appropriate equipment.

The complex of diagnostic and treatment measures should include the following areas:

Combating existing cerebral edema and its progression;

Clarification of the causes of cerebral edema and their elimination;

Treatment of concomitant manifestations that aggravate the condition of patients.

Dehydration therapy

It involves removing excess fluid from tissues. This goal can be achieved by using the following drugs:

Loop diuretics – Trifas, Lasix, furosemide. Their dose must be very high, which is necessary to create a high concentration and rapid onset of the diuretic effect;

Osmotic diuretics – beckons. Appointed first. After its infusions, the introduction of loop diuretics is recommended. This combination of drugs will have the maximum dehydration effect;

L-lysine escinate. The drug does not have a diuretic effect, but perfectly removes fluid from tissues, reducing signs of edema;

Hyperosmolar solutions – magnesium sulfate 25%, glucose 40%. They briefly increase plasma osmotic pressure, enhancing the diuretic effects of diuretics. Additionally, they supply ischemic brain cells with nutrients.

Adequate oxygenation and improved brain metabolism

Achieved by:

Instillation of humidified oxygen or artificial ventilation;

Local hypothermia by placing containers filled with ice around the head;

Administration of drugs that improve metabolic processes in affected brain cells (Actovegin, Mesquidol, Ceraxon, Cortexin);

Glucocorticoid hormones. Their action is to membrane stabilization of affected cells and strengthen the weakened vascular wall of the microvasculature.

Eliminating the cause and accompanying symptoms

Cerebral edema in most cases is accompanied by various cerebral and extracerebral manifestations, which became its cause or consequence.

Fluid can accumulate in the cells and interstitial space of the main regulatory organ of the central nervous system. This leads to edema or swelling of the brain, which provokes an increase in its volume and an increase in intracranial pressure. This condition is considered an extremely dangerous pathology that requires immediate treatment.

It is impossible to treat such a disease at home. If you suddenly suspect any bad symptoms in yourself or your loved ones, you need to call a doctor. Do not delay going to the doctor, as this will lead to death or disability. If you contact a specialist in time, you can quickly recover, completely eliminating the swelling.

Traditional method Treatment of edema consists of medicinal and surgical methods:

Have you tried many methods, but nothing helps?
Another coding turned out to be ineffective?
Is alcoholism destroying your family?

Like any form of addiction, alcoholism must be treated comprehensively, combining drug therapy, physical therapy and the help of a psychotherapist. Treatment in a psychoneurological hospital, under the supervision of specialists, is preferable.

In the chronic form, it is possible to induce an insulin coma or use electric shock. Treatment is carried out under the constant supervision of doctors. If the patient becomes violent, he is given an injection with an increased dose of psychotropic drugs.

In the event that alcohol dependence has not yet passed the stage of development of mental disorders and personality disintegration, it is possible to carry out treatment at home. It can also be taken orally and used in the form of droppers.

The principle of action is as follows: when drinking alcohol, even in small doses, it interacts with a substance - an antagonist based on disulfiram, which can lead to death. It is the patient’s fear of death that determines the therapeutic effect of this method.

All of the above methods of treating alcoholism are possible only with the conscious decision of the patient himself to change his life. In the case when alcoholism has developed into the stage of mental disorder and personality disintegration, its treatment is possible only in the conditions of a psychiatric department of a hospital.

The appearance of such symptoms should prompt you to immediately contact a good specialist. Delay can result in death. It is better to find out that the alarm was false than to hear that the call to a specialist was made too late.

It is impossible to get rid of the pathology with the help of medications alone. Their use accompanies various surgical techniques. The choice of drugs and the specifics of treatment are determined exclusively by a specialist, taking into account all the features of the course of the disease.

The medicinal side of the issue is represented by a set of drugs that meet two main objectives:

Direct relief of swelling. The most popular in this case are Mannitol, Furosemide and Dexamethasone. Betaspan, Prednisolone, Eufillin are prescribed in tablet form.
Relieving alcohol addiction. Esperal and Disulfiram are used.

In addition, it is necessary to saturate the brain cells with oxygen. Oxygen therapy allows you to achieve results. The essence of the method comes down to the artificial supply of oxygen, for example through an inhaler.

A recent solution in medical practice has been the technique of lowering body temperature, which provokes a reduction in swelling.

To get rid of high blood pressure, a catheter is used to pump out accumulated fluid from the ventricles of the brain. As a result of the disease, the body becomes depleted extremely quickly.

He does not have the ability to resist various infections, so the patient is administered various drugs to maintain pressure and blood flow within normal limits intravenously.
.

All procedures are carried out in a hospital setting so that the attending physician can constantly monitor the dynamics of changes in the patient’s condition. After the procedures, the patient does not go home immediately.

He still needs to undergo a rehabilitation course, as a result of which the consequences of the condition will be minimized, as well as the risk of relapse (provided he refrains from further drinking alcohol).

Corticosteroids and barbiturates inhibit further development of edema and relieve seizures. Thanks to their effects, blood circulation in the brain area is restored.

Drugs like Cavinton are prescribed to improve blood quality while simultaneously restoring vascular tone. Relief is obtained not only by patients with cerebral edema, but also by those who suffer from swelling of the legs.

With the help of nootropics Piracetam, Pantogam and the like, metabolism is restored in neurons. Cell membranes need stabilization.

To do this, take Troxevasin and Dicynon.
.

Possible consequences

Brain swelling is considered one of the most critical conditions. In especially severe cases, the body may simply not respond to treatment, and the patient will be doomed to death. Possible consequences depend on the degree of damage to the brain structure and the patient’s condition.

If the closed space of the skull is completely filled, the fluid will simply compress the brain. A similar prognosis is typical for half of the cases. The result is disruption and stoppage of the heart/lungs.

But the outcome may be more optimistic. If a person is taken to the intensive care unit on time, and his health condition is normal, then it is possible to eliminate the edema with or without neurological consequences.

Important: neurology studies the state of the nervous system, deals with the functionality, diagnosis, symptoms and development of the central/peripheral nervous system.

Neurological consequences include sleep disturbances, frequent headaches, confusion, physical exhaustion and vulnerability to depression. The intensity of symptoms depends on the timely provision of therapy and basic indicators of the body.

Some patients will not notice much discomfort, while others will have to undergo an additional therapeutic course to eliminate the neurological consequences. Individual treatment and recovery plan should be drawn up by the attending physician.

At the beginning of the development of the pathological process, it is premature to talk about the prognosis - it depends on the cause of the formation of edema, its type, localization, rate of progression, general condition of the patient, the effectiveness of therapeutic (or surgical) measures, and, possibly, on other circumstances that are immediately difficult notice.

Meanwhile, the development of OGM can go in different directions, and the prognosis, and then the consequences, will depend on this.

Without consequences

In rare cases, doctors are able to completely eliminate tissue swelling. More often complicated by cerebral edema - consequences:

mental disorders;
cognitive impairment;
paralysis and paresis;
disability (depending on the affected parts of the brain);
absent-mindedness;
sleep disorders;
depression;
memory problems;
chronic headaches;
increased intracranial and blood pressure;
deterioration in motor activity.

Cerebral edema - prognosis for life

Cerebral edema is one of the most critical conditions for humans. Often the body may not respond to the treatment, in which case the prognosis will be disastrous. Depending on the degree of damage to the brain structure, the following consequences of cerebral edema can be distinguished:

Progression of edema and swelling of the brain. Such a consequence threatens a person with death. When the free space of the cranium is filled with fluid to a critical state, the brain is compressed. As a result, dense structures are dislocated into softer ones, and a person experiences a disruption in the functioning of the lungs and heart, followed by their stoppage. This prognosis for edema is observed in 50 cases out of 100.
Elimination of edema without consequences. This outcome of events is very rare and can only occur in adults whose health is normal. Usually these are young people with alcohol intoxication who were taken to the intensive care unit on time. If the concentration of alcohol in the blood turns out to be not lethal, then the swelling can be removed without consequences for health.
Elimination of edema with neurological consequences. This occurs when the brain damage is minor and diagnosed in time (for example, with meningitis, with injuries after mild concussions). As a result of the operation, the swelling is eliminated. Neurological consequences include sleep disturbances, depression, headaches, absent-mindedness and decreased physical activity. In some cases, the neurological deficit may be minimal.

Maintaining the vital functions of the body is possible only with the use of special equipment - ventilation, artificial maintenance of the circulatory system.

It is recommended to treat the toxic effects of edema in a toxicology or drug addiction department, especially if the person has fallen into a coma. Brain damage from alcoholism leads to disruption of the heart and lungs and can cause disability or death.

Alcoholic cerebral edema develops quickly and is difficult to treat. Most often it leads to coma and death. The consequences of untimely treatment are as follows:

Partial or complete memory loss.
Gradual failure of all vital systems.
Increased intracranial pressure, which leads to hemorrhages, convulsions, and hallucinations.
Paralysis, loss of consciousness, coma.
Death of brain neurons, which leads to irreversible consequences: dementia, loss of consciousness.

A person suffering from alcoholism cannot adequately assess the situation. Most often, the first symptoms of pathology are not noticed. Impaired coordination, lack of cognitive function, and headache are mistaken for intoxication or a hangover. Therefore, to prevent cerebral edema, it is recommended to give up alcohol.

If symptoms of swelling appear, you should consult a doctor. If signs of pathology develop rapidly, call an ambulance. Fluid retention leads to the death of neurons. As a result, the person remains disabled for life or falls into a coma and quickly dies.

Swelling can put pressure on other centers of the brain, such as those responsible for breathing. Edema can completely block the access of oxygen to these areas. The further most likely development of events looks like death. A transition to a coma followed by respiratory arrest is possible.

1. It is no secret that delirium tremens is the result of a lack of vitamin B in the body; fever can also overtake relatively non-drinking people; its manifestations are found among patients with diseases of the central nervous system, as well as those who have fallen into the hands of a poisonous alcohol surrogate.

Delirium tremens is an acute alcoholic psychosis.

consequences of delirium tremens. What are they?

Strokes have different etiologies and are caused by numerous causes. One of these reasons is alcoholism. Alcohol has a detrimental effect on the blood vessels of the brain, which can result in rupture and hemorrhage.

For people who are on a drinking binge, micro-strokes can be especially dangerous. The signs of a mini-stroke are very similar to the signs of a hangover:

headache;
dizziness;
nausea;
confusion;
slurred speech;
loss of orientation in space.

Treatment and prevention

You can prevent such a dangerous disease if you follow the simplest safety rules:

You need to monitor your blood pressure and try to maintain it within normal limits.
It's better to give up everyone bad habits, especially from drinking alcohol.
If possible, use protective equipment to protect your head from injury.

Long-term alcohol intoxication when consuming alcohol substitutes often leads to damage to many vital functions of all internal organs. Brain hypoxia, heart damage, paralysis of the respiratory center, and death may occur. Liver damage leads to obesity and cirrhosis.

alko03.ru

It is possible to prevent the manifestation of this pathology, as well as the consequences associated with it, if each person follows a number of simple recommendations for their own health:

It is necessary to keep your own blood pressure under control and strive to maintain it at a normal level.
Try to limit yourself from any negative habits. This is especially true for drinking strong drinks.
If a person is closely associated with a job where any kind of injury can easily occur, then you should be safe and wear specialized equipment that will protect you from bodily harm, including traumatic brain injury.

Long-term binges, during which large amounts of alcoholic beverages of surrogate origin are consumed, lead to damage to many internal organs, which entails negative consequences and death.

Alcoholic drinks cause a feeling of euphoria, while the person has no idea what danger he is exposed to. Alcoholism has a detrimental effect on all human organs. Alcohol has the most dangerous effect on the nervous system, in particular on the brain. A feast with drinking strong drinks threatens the death of brain cells, and sometimes causes death.

What is cerebral edema

Tissue swelling is a completely natural process, but not in the case when cerebral edema occurs. The brain is in a closed space, so it should not increase in volume. The skull cannot expand under the influence of increased contents, which leads to compression of the brain. It is this condition that is dangerous - neuronal ischemia worsens and swelling spreads. An increase in brain volume in a confined space reduces brain function and disrupts metabolic processes.

Causes of cerebral edema formation

Causes of cerebral edema:

ischemic or hemorrhagic stroke;
cerebral hemorrhages;
cancer of the intracranial space (glioblastoma, astrocytoma, meningioma);
metastases;
fracture of the vault or base of the skull with brain damage;
meningoencephalitis and meningitis;
hematoma formation due to intracranial damage;
brain damage and contusion due to mild concussions;
renal and liver failure with disruption of the normal functioning of these organs;
brain surgery;
swelling due to heart failure;
anaphylactic shock;
intoxication (alcohol, toxic compounds and poisons).

Sometimes it is very difficult to determine what causes cerebral edema. Local swelling of tissues turns into general edema under the influence of many factors - the patient’s age, gender, concomitant diseases, localization of pathological processes.

The effect of alcohol on the brain

When drinking alcohol, ethyl alcohol enters the brain through the vessels and destroys the cerebral cortex. Alcohol intoxication is a consequence of disorders in the functioning of the brain. This condition occurs in adults in the following cases:

Damage to neurons in the occipital part of the brain, namely the vestibular apparatus. This phenomenon leads to a lack of coordination.
Damage to the lower part of the frontal lobe of the brain. If the functioning of this part is disrupted, a person’s moral principles are erased, he ceases to be shy and becomes more courageous.
Damage to cells responsible for memory. A sober person rarely remembers his actions while drunk.
Impaired cognitive functions.

When drinking alcohol regularly, a person is unable to think rationally and adequately assess the situation. Nerve cells in the brain undergo regular damage, so the brain significantly reduces its field of perception. A drunk person is able to remember information to a much lesser extent than a sober person. A person with an alcohol addiction may experience hallucinations even when sober.

With moderate consumption of alcoholic beverages, cognitive functions are restored within a day, but the recovery time is influenced by the person’s health status. If the functioning of the liver and kidneys is impaired, the damage can be much more serious, which means that brain function will take much longer to recover.

Symptoms of cerebral edema

The diagnosis of cerebral edema is made to people with severe alcohol intoxication. The cause of edema is high permeability of blood vessels due to the use of ethyl alcohol.

Symptoms of edema due to alcohol poisoning are similar to general symptoms.

Toxic edema can be identified when the patient exhibits the following signs in appearance:

normal build with a large belly and thin limbs;
puffy face;
the skin is covered with hematomas and peels off.

Brain edema in alcoholism is accompanied by the following symptoms:

severe persistent headaches;
pain in the cervical region;
numbness of the skin;
labored breathing;
memory loss;
loss of consciousness;
severe cramps;
nausea, vomiting;
increased blood and intracranial pressure;
slow heart rate;
drowsy state;
changes in the fundus, and sometimes decreased vision or blindness;
persistent feeling of anxiety;
in some cases, coma occurs;
with focal brain damage, the patient exhibits signs of impaired coordination, paralysis of a body part, speech disorders, and hallucinations.

The listed symptoms of cerebral edema also occur with small doses of alcohol. The signs are influenced by the stage of the disease and the individual characteristics of the drunk person.
Edema as a result of alcohol intoxication is a cause of death if the concentration of alcohol in the blood of a sick person is 5000 mg/l.

Consequences for the body with cerebral edema

Progression of edema and swelling of the brain. Such a consequence threatens a person with death. When the free space of the cranium is filled with fluid to a critical state, the brain is compressed. As a result, dense structures are dislocated into softer ones, and a person experiences a disruption in the functioning of the lungs and heart, followed by their stoppage. This prognosis for edema is observed in 50 cases out of 100.
Elimination of edema without consequences. This outcome of events is very rare and can only occur in adults whose health is normal. Usually these are young people with alcohol intoxication who were taken to the intensive care unit on time. If the concentration of alcohol in the blood turns out to be not lethal, then the swelling can be removed without consequences for health.
Elimination of edema with neurological consequences. This occurs when the brain damage is minor and diagnosed in time (for example, with meningitis, with injuries after mild concussions). As a result of the operation, the swelling is eliminated. Neurological consequences include sleep disturbances, depression, headaches, absent-mindedness and decreased physical activity. In some cases, the neurological deficit may be minimal.

Treatment

Cerebral edema is a disease that cannot be treated independently without the involvement of specialists. Treatment of cerebral edema must be carried out in a hospital setting, which is associated with a threat to human life, especially if the person is in a coma. Maintaining the vital functions of the body is possible only with the use of special equipment - ventilation, artificial maintenance of the circulatory system.

Swelling that occurs after mild concussions or a mild form of mountain sickness in most cases does not require treatment, but in other situations immediate assistance from specialists is required.

Treatment measures are aimed at:

combating edema and preventing brain swelling;
eliminating the causes of edema;
treatment of concomitant diseases that aggravate the patient’s condition.

First aid

Before sending the patient to the intensive care unit, he needs to be assisted:

Local hypothermia (the head of a sick person is covered with ice to prevent the development of swelling and cooling of the head). This method is suitable if a person is in a coma.
Intravenous administration of glucose solution.
Administration of glucocorticoids (to strengthen the walls of blood vessels).
Administration of furosemide (to relieve blood pressure, pressure in the lungs).
Oxygen inhalation (for pulmonary edema and breathing problems).
Administration of Piracetam intravenously (to restore brain function and metabolism).

Oxygen therapy. Humidified oxygen is introduced into the respiratory tract using special equipment or artificial ventilation. This procedure restores oxygen exchange and improves brain nutrition.
Hypothermia. The procedure is performed to artificially lower body temperature and reduce brain swelling.
Intravenous infusion. The effect is aimed at maintaining pressure, improving blood flow and combating infectious pathogens
Ventriculostomy. Drainage of excess fluid from the ventricles of the brain through a catheter to reduce intracranial pressure.
Drug treatment. Treatment with drugs depends on the cause of the swelling. Usually, Esperal and Teturam are prescribed for the treatment of alcohol addiction. All other drugs are prescribed only after treatment of alcoholism. Usually these are sedatives, nootropics. To improve blood supply and reduce oxygen starvation, Actovegin and Cerebrolysin are prescribed.
Surgical intervention. In some cases, surgery is not possible. During surgery, part of the skull bone is removed, which reduces intracranial pressure and swelling. Craniotomy is aimed at preventing brain herniation. During surgery, you can find out the cause of the swelling. If necessary, the formation is removed and the damaged blood vessel is restored.

Edema develops rapidly, but with timely assistance, the prognosis for treatment can be favorable. To do this, you need to consult a doctor as soon as the first signs of the disease appear.

Alcohol is an unconditional evil that mercilessly and persistently harms the health and well-being of people. People who drink heavily expose their bodies to destruction. All organs without exception suffer from alcohol intoxication; the cardiovascular system is subjected to severe attacks. The mind and soul of a person becomes a victim of intoxicating drinks. The central nervous system experiences the strongest pressure.

Brain edema due to alcoholism can lead to serious complications that are detrimental to health. Researchers claim that alcohol enters the brain a few seconds after consumption, however, everyone can confirm this statement from their own experience. Within minutes, changes begin to occur at the micro level. Brain cells absorb the sugar contained in alcohol instead of their usual treat - glucose. The brain absorbs destructive energy from alcoholic drinks.

With alcoholism, the concentration of creatine and homen, which protect brain cells, decreases. Alcohol affects the cell membranes of the brain. With alcoholism, changes in the brain matter become irreversible. Systematic intake of intoxicating drinks over a long period of time lays the foundation for the gradual destruction of the brain. At the very beginning of the process of alcohol abuse, neurons die, which leads to a decrease in brain volume and the formation of microtraumas and ulcers. Medical experts compare brain damage caused by alcoholism with severe traumatic brain injury and argue that these processes are similar in harmfulness.

Features of the pathology of cerebral edema

When drinking alcohol regularly, fluid accumulates in the brain as a result of alcohol poisoning. The pathological condition occurs due to wear and tear of blood vessels and increased permeability of their walls to the harmful attacks of alcohol. For a long time, this pathology does not manifest itself in any way, but then the disease begins to develop rapidly. Brain edema can be diagnosed by the following signs:

pain in the skull area;
severe pain in the neck;
the scalp becomes desensitized;
intermittent breathing caused by low tidal volume;
nausea, vomiting,
difficulties in coordinating body position, inspired by imbalance,
dizziness;
memory loss, complete or partial;
detachment from the environment with fragmentary perception of it or complete loss of consciousness;
slow heart rate, drowsiness;
involuntary innervation of muscles, mild paralysis.

The appearance of these symptoms urgently requires seeking medical help. The severity of the pathology will depend on the individual characteristics of the patient's health status. With alcoholism, the disease can occur with complications.

Diagnosis of the disease

It is currently possible to recognize the disease and make a diagnosis of cerebral edema in the initial stages. The following will help diagnose the disease and determine treatment methods:

echoencephalography - examination of the head using ultrasound echography, which is based on sending ultrasonic impulses deep into the brain area, since they are reflected from the brain matter and form an image of the brain structure on the screen;
electroencephalography is a graphical reflection of the electrical activity of the brain; the recorded electroencephalogram is used to determine the location and size of the damage.
computed tomography is a method of computer data processing that is based on the attenuation of x-ray radiation when passing through tissues of different densities.
magnetic resonance imaging - with this research method, electromagnetic signals of atomic nuclei in a magnetic field are measured, the responses are processed by a computer and displayed as images on the screen.

All these high-tech devices will help determine pathology parameters with high accuracy. If cerebral edema is confirmed, it is necessary to immediately begin treatment under the guidance of a medical specialist. Under no circumstances should a patient be treated at home, since cerebral edema is a life-threatening pathology that can be fatal. Delay in placing the patient in a hospital will aggravate the manifestations of the disease and cause injuries incompatible with life. But with timely access to qualified medical care, modern drugs and special methods will make it possible to produce effective treatment and bring the patient out of a harmful state.

Drug and surgical treatment

Cerebral edema is predominantly treated with complex methods, which involve the use of medications along with the possibility of surgical therapy. Brain edema is treated with medications and their prescription depends on the symptoms that accompany the development of the pathology. Additionally, alcohol dependence is treated, since if the patient does not stop drinking alcohol, all other methods will not bring the desired effect. Brain edema is relieved with drugs that are introduced into the body in the form of solutions and tablets, including:

Dexamethasone;
Mannitol;
Furosemide.

And only in tablet form:

Metipred;
Prednisolone;
Eufillin;
CO-Trimoxazole-Acree;
Betaspan;
Tromethanol-N.

You can overcome alcohol addiction by undergoing treatment with the following drugs:

Teturam.
Esperal;
Disulfiram;
Proprothene-100;

The arsenal of surgical therapy is quite wide, and its use is highly effective. Treatment methods include the following:

hypothermia - cerebral edema is corrected by artificially reducing body temperature, the method is quite new for therapy in our country and is not widely used, as it has not received proper distribution;
ventriculostomy - pumping out cerebrospinal fluid from the ventricles of the brain, the procedure is performed through a catheter and reduces intracranial pressure.
Oxygen therapy is an operation whose effect is that oxygen enters the patient’s respiratory tract, this happens forcibly using an inhaler or similar instrument, oxygenated blood enters the brain and helps overcome cerebral edema;
drip intravenous infusion a complex of medicines allows you to enrich a weakened body with vitamins and essential substances;
the introduction of therapeutic drugs intravenously helps to create optimal blood flow pressure and helps the body, weakened by the disease, in the fight against pathogens;
decompressive craniectomy - removal of a section of skull bone in order to reduce intracranial pressure, used in extreme cases;
surgery to remove a tumor or repair a defective blood vessel to eliminate the source of swelling.

All of the above remedies can be used as prescribed by the attending physician in combination:

with corticosteroids, which inhibit the development of the disease;
with drugs that normalize vascular tone and blood properties;
with barbiturates, which reduce seizure activity;
with drugs that help stabilize cell membranes;
with nootropics that normalize metabolism in neurons.

The treatment ahead is serious, and it must be carried out in a hospital under the constant supervision of specialists. Once again I would like to draw your attention to the fact that self-medication is unacceptable. People who abuse alcohol should take into account the risk of diseases, one of which is cerebral edema, and give up the addiction. If you cannot do this on your own, you need to involve a narcologist in this process. It will help you get rid of addiction and maintain health and longevity.

Psychoneurological disorders in acute poisoning consist of a combination of mental, neurological and somatovegetative symptoms due to a combination of direct toxic effects on various structures of the central and peripheral nervous system and lesions of other organs and systems that develop as a result of intoxication.

Disturbances of consciousness are manifested by depression (stupefaction, somnolence, coma) or excitement (psychomotor agitation, delirium, hallucinations) of mental activity, often replacing each other. The most severe cases are acute intoxication psychosis and toxic coma.

Toxic coma is more often observed in case of poisoning with substances that have a narcotic effect, although severe poisoning with any toxic substances with a sharp disruption of the vital functions of the body (blood circulation, respiration, metabolism, etc.) can be accompanied by profound inhibition of brain functions.

Clinical manifestations of coma in acute poisoning are caused in the toxicogenic stage by the direct specific effect of poisons on the central nervous system, and in the somatogenic stage of poisoning they are determined by the development of endotoxicosis.

The general neurological picture of toxic coma in the early toxicogenic stage is characterized by the absence of persistent focal neurological symptoms (symmetrical neurological signs predominate) and rapid positive dynamics of neurological symptoms under the influence of adequate emergency treatment measures.

Each type of toxic coma, caused by the action of a certain group of toxic substances, is characterized by its own neurological symptoms, most clearly manifested at the stage of superficial coma. Along with narcotic toxic coma, with neurological symptoms of superficial or deep anesthesia (muscular hypotonia, hyporeflexia), comatose states with severe hyperreflexia, hyperkinesis, and convulsive syndrome are observed.

The most noticeable in the neurological picture of acute poisoning, in particular coma, are the following somato-vegetative disorders: symmetrical changes in the size of the pupils, sweating disorders with dysfunction of the salivary and bronchial glands.

With M-cholinomimetic (muscarinic-like) syndrome Miosis, hyperhidrosis, hypersalivation, bronchorrhea, pallor of the skin, hypothermia, bronchospasm, bradycardia, hyperperistalsis, caused by an increase in the tone of the parasympathetic division of the autonomic nervous system, are observed. Develops from poisoning with substances that have M-cholinergic activity (muscarine, organophosphorus compounds, barbiturates, alcohol, etc.).

With M-cholinergic (atropine-like) syndrome Mydriasis, hyperemia, dry skin and mucous membranes, hyperthermia, and tachycardia are observed. Develops from poisoning with substances that have an anticholinergic effect (atropine, diphenhydramine, amitriptyline, asthmatol, aeron, etc.).

Adrenergic syndrome caused by cocaine, ephedrine, amphetamines, melipramine, aminophylline, etc. Manifested by hyperthermia, impaired consciousness, agitation, hypertension, tachycardia, rhabdomyolysis, DIC syndrome.

Serotonergic syndrome has been described in recent years and is sometimes life-threatening. Caused by a large group of drugs - selective agonists of serotonergic receptors (buspirone, cisapride, new generation antidepressants, etc.), manifested by hyperthermia, impaired consciousness, vegetative dystonia (profuse sweat, pressure instability are observed), hyperreflexia, myoclonus, trismus, muscle rigidity. Characterized by rapid reverse development.

Miosis cause substances that increase the activity of the cholinergic system: M-cholinomimetics (muscarine, pilocarpine), anticholinesterases with an M-choline potentiating effect (aminostigmine, organophosphorus compounds, etc.); opiates, reserpine, cardiac glycosides, barbiturates, etc. as well as substances that reduce the activity of the adrenergic system: clonidine and its homologues, depressants; industrial agents (carbamate insecticides).

Midriaz cause substances that increase the activity of the adrenergic system: indirect adrenergic agonists (amphetamines, ephedrone, cocaine), catecholamine precursors (L-DOPA, dopamine), inhibitors of enzymes that inactivate catecholamines (MAO inhibitors); LSD; substances that reduce the activity of the cholinergic system: atropine and its homologues, antihistamines, tricyclic antidepressants.

Toxic encephalopathy- the occurrence of persistent toxic damage to the brain (hypoxic, hemodynamic, liquorodynamic with degenerative changes in brain tissue, edema of the meninges, plethora, disseminated areas of necrosis in the cortex and subcortical formations). The most well-known psychoneurological symptoms of toxic encephalopathy are poisoning with compounds of heavy metals and arsenic, carbon monoxide, opiates, as well as substance abuse.

Brain swelling- a complication of toxic coma, accompanied by a variety of neurological symptoms corresponding to the topic of the lesion: transient paralysis, hemiparesis, pyramidal signs, cerebellar and extrapyramidal symptoms, epileptiform convulsions, hyperthermia, bulbar disorders, etc. Characteristic features Brain edema is congestion in the fundus of the eye, such as swelling of the optic discs, lack of pulsation, dilated veins and an increase in the size of the blind spot. Signs of intracranial hypertension are detected - stiff neck, tension in the eyeballs, bradypnea, bradycardia, etc. During a spinal puncture, an increase in intracranial pressure is determined. Treatment of toxic cerebral edema is aimed primarily at reducing intracranial pressure and reducing the hydrophilicity of brain tissue. Dehydration therapy with osmotic diuretics, hypertonic glucose solutions, glycerin, and repeated spinal punctures reduces cerebral edema.

Lifetime brain death- the most severe and irreversible complication of toxic coma with symptoms of hypoxia and edema of brain tissue. Brain vitality is determined by EEG. In acute poisoning with sleeping pills and drugs that cause deep but reversible anesthesia, intravital brain death can be judged only after 30 hours of continuous recording of isoelectric EEG.

Treatment of toxic coma requires strictly differentiated measures. Along with accelerated detoxification, specific (antidote) and symptomatic therapy, treatment of exotoxic coma includes the use of drugs aimed at combating homeostasis disorders and hypoxia. This is achieved by introducing vitamin preparations, nootropics and antihypoxants. A number of studies have shown the high effectiveness of complex metabolic agents based on succinic acid: reamberin (adults - intravenous drip up to 60 drops per minute up to 800 ml/day; children - 10-15 ml/kg 2 times a day) and cytoflavin (10.0-30.0 in a 5% glucose solution - 400 ,0 or in 0.9% sodium chloride solution at a rate of no more than 90 drops/min 2 times a day).

Acute intoxication psychosis- mental disorder with a predominance of symptoms of “floating” consciousness, hallucinosis (usually visual and tactile), catatonic disorders. Observed when exposed to psychotomimetic substances (cocaine, marijuana, LSD, phenamines), carbon monoxide, tetraethyl lead, bulbocapnin (catatonia). Poisoning with anticholinergic drugs (atropine, atropine-like, antihistamines, amitriptyline) is accompanied by central anticholinergic syndrome. Fixation of the patient and detoxification (infusion) therapy are necessary. Psychosis can be treated with modern psychotropic drugs (diazepam, aminazine, tizercin, haloperidide, sodium hydroxybutyrate) regardless of the type of poisoning.

Convulsive syndrome. In case of poisoning, clonic (corazole, cicutotoxin), clonic-tonic (physostigmine, organophosphorus poisons) and tonic (strychnine) convulsions can occur. In case of poisoning with anticholinesterase poisons, general convulsions are preceded by intense myofibrillations. A patient requires emergency care if a convulsive syndrome develops due to poisoning with strychnine, amidopyrine, tubazide, organophosphorus substances, etc.

First of all, the airway should be restored and sibazone (diazepam, seduxen) should be administered - 10-60 mg (0.5% - 2.0-4.0-6.0) IV.

Toxic hyperthermia may develop as a result of central disturbances of thermoregulation during poisoning with amphetamines, anesthetics (initial stage), zincofene, cocaine, dinitrocresol, dinitrophenol, ecstasy and its derivatives, MAO inhibitors, phenothiazines, theophylline, salicylates, serotonergic drugs, succinylcholine, xanthines. Most often, hyperthermia can be caused by infectious complications (such as pneumonia, including aspiration, bacteremia and septicemia in drug addicts, etc.). Convulsive syndrome may be accompanied by hyperthermia.

With the development of hyperthermia syndrome of central origin (to differentiate from febrile conditions with pneumonia), craniocerebral hypothermia, repeated spinal punctures, and administration of a lytic mixture are necessary: aminazine solution 2.5% 1.0-3.0, diprazine solution (pipolphen) 2.5 % 2.0 and 50% analgin solution - 1.0-3.0.

Toxic hypothermia- decrease in body temperature below 35 °C. Hypothermia can be observed in case of poisoning with alcohol, central analgesics, anesthetics, tricyclic antidepressants, barbiturates, benzodiazepines, carbamates, clonidine, cyanides, chloral hydrate, methyldopa, carbon monoxide, phenothiazines. In case of drug poisoning, it occurs in 7-10% of cases. The main way to combat toxic hypothermia is to carry out detoxification measures.

Toxic visual, auditory neuritis and polyneuritis develop in acute poisoning with methyl alcohol, quinine, salicylates, antibiotics, organophosphorus substances, thallium, arsenic, and magnesium salts.

Impaired color vision is observed in cases of poisoning with salicylates, aconite, digitalis, etc.

Respiratory dysfunction syndrome

Respiratory disorders in acute poisoning manifest themselves in various clinical forms.

Aspiration-obstructive form most often observed in a comatose state with blockage of the airways as a result of retraction of the tongue, aspiration of vomit, severe bronchorrhea and salivation. In these cases, it is necessary to remove vomit from the mouth and pharynx with a swab, suck out mucus from the pharynx using an electric suction device, remove the tongue with a tongue holder and insert an air duct, perform tracheal intubation, and sanitation of the tracheobronchial tree. In case of severe salivation and bronchorrhea, a solution of atropine sulfate 0.1% 0.5-1.0 s.c. is administered.

In cases where asphyxia is caused by a burn of the upper respiratory tract and swelling of the larynx due to poisoning with cauterizing poisons, an urgent operation is required - tracheostomy.

Neurogenic form of breathing disorders develops against the background of a deep coma or during poisoning with substances that selectively depress the respiratory center (opiates), and is manifested by the absence or obvious insufficiency of independent respiratory movements. Disturbances in the function of the respiratory muscles are most often caused by disorganization of their nervous regulation and disruption of neuromuscular conduction due to poisoning with anticholinesterase and curare-like substances. Artificial ventilation is required.

Pulmonary form of breathing disorders associated with the development of a pathological process in the lungs (pneumonia, toxic pulmonary edema, tracheobronchitis, etc.).

Pneumonia- the most common cause of late respiratory complications in poisoning. Most often observed in patients in a coma or with burns of the upper respiratory tract with cauterizing substances. Having a predominantly hypostatic or aspiration-obstructive nature in the first hours of the development of a coma, pneumonia subsequently acquires an infectious nature. In this regard, in all cases of severe poisoning with respiratory problems, early adequate antibacterial therapy is necessary. Timely detoxification and activation of the patient prevent the development of pneumonia.

Toxic pulmonary edema(respiratory distress syndrome) occurs under the influence of asphyxiating toxic substances (chlorine, phosgene), cauterizing gases and vapors (nitrogen oxides, ammonia), toxic fumes, heroin, cocaine, chloroquine, paraquat, colchicine, salicylates, etc. For treatment, it is necessary to administer prednisolone 30-60 mg in a 40% glucose solution 20.0 IV (repeat if necessary), 30% urea solution 100.0-150.0 or Lasix 80-100 mg.

Oxygen therapy. Use of defoamers. Inhalation or parenteral administration diphenhydramine, ephedrine, novocaine.

Bronchospastic syndrome occurs in case of poisoning with cholinergic (cholinomimetic) substances (acetylcholine, muscarine, physostigmine, organophosphorus poisons), poisoning with toxic gases, beta-blockers.

Airway irritation syndrome manifested by pain and catarrhal symptoms along the airways. Poisonous substances with a sneezing effect (sternites) are especially potent.

Hypoxia. A special form of respiratory disorders is hemic hypoxia during hemolysis, methemoglobinemia, carboxyhemoglobinemia, as well as tissue hypoxia due to blockade of respiratory enzymes in tissues during poisoning with cyanides and carbon monoxide.

Hyperbaric oxygen therapy and specific antidote therapy are important in the treatment of this pathology.

Syndrome of dysfunction of the cardiovascular system

The most common dysfunctions of the cardiovascular system in acute poisoning are exotoxic shock, acute cardiovascular failure (primary toxicogenic and secondary somatogenic collapse, hemodynamic pulmonary edema), acute heart failure (threatening cardiac rhythm and conduction disorders, cardiac arrest), primary hypertensive syndrome.

Exotoxic shock. observed in most severe acute intoxications, refers to early dysfunction of the cardiovascular system in the toxicogenic phase of poisoning. It is manifested by a drop in blood pressure, pale skin, tachycardia, shortness of breath, and decompensated metabolic acidosis develops. When studying hemodynamics during this period, a decrease in the volume of circulating blood and plasma, a drop in central venous pressure, a decrease in stroke and cardiac output are noted, which indicates the development of relative or absolute hypovolemia.

The following stages of shock are distinguished:

1) a critical condition for the occurrence of shock (pre-shock);

1st degree the severity of shock is determined by threshold or critical concentrations of the chemical that caused the poisoning. Consciousness of patients is often preserved (in case of poisoning with sleeping pills, it is absent), the victims are excited or inhibited. Pulse is weak, frequent; Blood pressure not lower than 90 mm Hg. Art. Moderate oliguria (up to 20 ml/hour). Intensive antishock therapy for 6 hours has a positive effect.

The second degree is due to critical concentrations of a toxic substance in the body. Consciousness can be preserved, but patients are sharply inhibited and adynamic. Pallor and acrocyanosis, severe shortness of breath, tachycardia, oliguria (less than 20 ml/h), blood pressure below 90 mm Hg are noted. Art. A tendency to restore hemodynamic parameters is observed after 6-12 hours or more against the background of anti-shock measures.

The third degree is caused by critical or lethal concentrations of the chemical substance that caused the poisoning. Despite intensive anti-shock therapy for 6-12 hours, positive dynamics are either absent or are unstable.

IV degree - irreversible. In such cases, it is necessary to administer plasma-substituting fluids (polyglucin, rheopolyglucin), crystalloids, 10-15% glucose solution with insulin intravenously until the volume is restored and hemodynamic parameters are normalized. Typically, 2-3 liters of solutions are required, administered at a rate of 750-1000 ml/hour. Subsequently, supportive infusion therapy at a rate of 300-500 ml/hour. At the same time, hormonal therapy is carried out (prednisolone is used up to 500-800 mg/day intravenously). Inotropic support with sympathomimetic agents (norepinephrine, dopamine, dopamine, dobutrex) is extremely important. For metabolic acidosis, a 4% sodium bicarbonate solution of 400 ml or more is administered. In case of poisoning with cauterizing poisons (acids and alkalis), it is necessary to relieve the pain syndrome by administering a glucose-novocaine mixture (5% glucose solution - 500 ml and 2% novocaine solution - 50 ml IV), narcotic analgesics and neuroleptanalgesia.

Cardiogenic pulmonary edema occurs with left ventricular failure, overhydration, poisoning with cardiotoxic poisons, chloroquine, colchicine.

Toxic cardiopathy occurs when poisoning with cardiotoxic poisons (quinine, aconitine, veratrine, coumarin, barium chloride, pachycarpine, etc.) primarily acting on the heart - a direct cardiotoxic effect is possible, conduction disturbances (severe bradycardia, slowing of intracardiac conduction) with the development of collapse.

In such cases, a 0.1% solution of atropine sulfate is administered - 0.5-1.0-3.0 IV, a 4% solution of potassium chloride - 5.0-10.0 IV. Slowing of intraventricular conduction is caused by class 1 antiarrhythmic drugs, tricyclic antidepressants, quadricyclic antidepressants, chloroquine, some phenothiazines (chlorpromazine, thioridazine), some b-blockers (propranolol, oxprenolol, acebutol), dextropropoxyphene. Acceleration of intraventricular conduction is caused by meprobamate, some phenothiazines, carbon monoxide, opiates (vasodilation), and isopropyl alcohol. Ventricular tachycardia is caused by trichlorethylene, chloral hydrate, theophylline, tricyclic antidepressants, digitalis, and class 1 antiarrhythmic drugs.

Bradycardia cause ß-blockers, inhibitors calcium channels, digitalis, clonidine, anticholinesterase substances. It is necessary to monitor rhythm, hemodynamics, blood electrolytes, and in some cases, electrophysiological examination of the heart. The duration of rhythm monitoring is determined individually, but must be at least two half-lives of the poison.

Acute dystrophic lesions of the myocardium refer to later manifestations of poisoning and are expressed more clearly the longer and more severe the intoxication occurs. The ECG reveals changes in the repolarization phase. In complex therapy of acute toxic myocardial dystrophy, drugs that improve metabolic processes (B vitamins, cocarboxylase, ATP, etc.) should be used.

Toxic damage to the liver and kidneys

Clinical manifestations of toxic damage to the liver and kidneys are found in more than 30% of cases of acute poisoning. There are two main pathogenetic mechanisms for the occurrence of these lesions: specific and nonspecific.

For lesions of a specific nature, direct contact of the toxic substance with the parenchyma of the liver and kidneys is of primary importance.

Nonspecific toxic damage to the liver and kidneys develops secondarily as a consequence of pathological changes in the body caused by acute poisoning, one of which is a violation of regional circulation during exotoxic shock. Reduced blood supply leads to ischemic damage to the liver and kidneys.

Specific and nonspecific lesions of these organs mutually aggravate each other. Damage to the liver and kidneys in acute poisoning is due to the general phylogenetic and anatomical features of these organs and their close functional connection. This made it possible to identify a special hepatorenal syndrome of toxic etiology.

Toxic hepatopathy. Liver damage develops in acute poisoning with so-called hepatic poisons (dichloroethane, carbon tetrachloride), some plant poisons (toadstool, male fern) and medications (paracetamol, quinine), as well as in severe disorders of regional circulation and after liver diseases.

Pathomorphological changes in the liver in acute poisoning are relatively similar. Hepatotoxic substances cause liver failure, the morphological substrates of which are fatty and protein degeneration and necrosis of hepatocytes. In severe poisoning, regardless of the hepato- or nephrotoxic effect, pronounced disturbances in the hemodynamics of the liver are observed. Nonspecific liver damage also includes disorders of bile secretion such as cholestasis.

Clinically, hepatopathy is manifested by a complex combination of symptoms of exogenous toxicosis and endotoxemia caused by liver dysfunction. Its increase and pain, icterus of the sclera and skin are revealed. The appearance of jaundice is preceded by an increase in body temperature, sometimes prolonged.

In the diagnosis of liver pathology, the appearance in the vascular bed of highly soluble cytoplasmic enzymes (alanine and aspartic aminotransferases, etc.), a decrease in the activity of pseudocholinesterase in the serum, a decrease in the level of b-lipoproteins, cholesterol, phospholipids, albumin, an increase in bilirubin content, changes in bromsulfalein and others are important. samples Based on clinical and laboratory data, three degrees of severity of toxic hepatopathy are distinguished:

1) mild, characterized by the absence of clinical signs of liver damage; the severity of the patient’s condition is determined by the symptoms inherent directly in this intoxication. Liver dysfunction is detected only through laboratory and instrumental studies;

2) moderate, characterized by clinical signs of liver damage, such as enlargement and pain on palpation, hepatic colic, jaundice, hemorrhagic diathesis, in combination with more intense changes in laboratory and instrumental data;

3) severe, characterized by acute liver failure, which is accompanied by hepatic encephalopathy.

In acute liver failure, cerebral disorders (hepatic encephalopathy) occur - motor restlessness, delirium, followed by drowsiness, apathy, coma (hepatargia); phenomena of hemorrhagic diathesis (nosebleeds, hemorrhages in the conjunctiva, sclera, skin and mucous membranes). Liver damage is often combined with kidney damage (hepatorenal failure). The severity of toxic liver damage largely depends on the type of toxic substance that caused the poisoning. With large doses of poisons that cause rapid death, liver damage does not always have time to manifest itself. The most important method of treating toxic hepatopathy is massive plasmapheresis.

In case of liver failure, a solution of pyridoxine 5% is administered - 2.0 i/m, nicotinamide 1 g, cyanocobalamin 1000 g, a solution of glutamic acid 1% - 20.0-40.0 i/v, a solution of lipoic acid 0.5% - 20.0-30.0 IV, unithiol solution 5% - up to 40.0/day IV, cocarboxylase - 200 mg, glucose solution 10% - 750.0 and insulin 16-30 IU/day.

Effective methods Treatments include bougienage and catheterization of the umbilical vein with direct injection into the liver of the drugs listed above, drainage of the thoracic lymphatic duct, and hemosorption. In severe cases of hepatic-renal failure, hemodialysis is performed.

Toxic nephropathy. Kidney damage occurs during poisoning with nephrotoxic poisons (antifreeze, sublimate, dichloroethane, carbon tetrachloride, etc.), hemolytic poisons (acetic acid, copper sulfate), with deep trophic disorders with myoglobinuria (myorenal syndrome), as well as with exotoxic shock.

Exotoxic kidney damage can be divided into specific and nonspecific. Specific kidney damage occurs during acute poisoning with nephrotoxic substances, which during active transport cause destruction of the excretory epithelium of the tubules with the development of a general pathomorphological picture of necronephrosis. Nonspecific nephropathy can develop in cases of acute poisoning with almost any toxic substance with an unfavorable combination of disturbances in the body's homeostasis, a sharp decrease in blood pressure, disturbances of regional circulation in the kidneys and liver, disorders of water and electrolyte balance in severe dyspeptic disorders, uncompensated acidosis, chronic kidney diseases. The immunological aspect of the toxic effects of various drugs and chemicals is of great importance. Should be given Special attention prevention of possible development of acute renal failure.

Necrotic changes in the tubules in toxic nephropathy are caused by hypoxia developing as a result of hemodynamic or histotoxic effects, decreased glomerular filtration, blockade of the tubules by cellular debris, leakage of glomerular filtrate through damaged tubules, and interstitial edema.

Activation of the renin-angiotensin system causes vascular spasm (especially afferent arterioles), decreased glomerular filtration, and increased ischemia. A certain role in these processes belongs to histamine, serotonin, vasopressin, and some steroids that increase tissue sensitivity to hypoxia, reduce the synthesis and supply of vasodilating prostaglandins, and increase intracellular calcium concentration. Shunting of the blood flow is characteristic: the blood, bypassing the renal cortex, enters the system of direct arterioles of the medulla.

Morphological changes during ischemic changes (shock kidney) are manifested by blanching of the cortex, congestion of the juxtamedullary zone. Focal lesions of the tubular epithelium with a predominance of hydropic degeneration and rupture of the renal tubules are revealed. In the glomeruli of renal corpuscles, anemia, desquamation of endothelial cells with exposure of basement membranes, and subendothelial fibrin deposits are noted.

The development of disseminated intravascular coagulation syndrome leads to thrombosis of the glomerular capillaries and symmetrical cortical necrosis.

Ethylene glycol poisoning leads to symmetrical cortical necrosis of the kidneys, combined with glycol nephrosis. The kidney is enlarged and moist on section; Histologically, balloon degeneration of the epithelium of the renal tubules with oxalate crystals in their lumen and inside the cells is revealed.

The nephrotoxic effect of heavy metal salts is associated with the blockade of sulfhydryl groups of enzymatic and structural proteins and is manifested by coagulative necrosis of the epithelium of the renal tubules.

Chlorinated hydrocarbons cause fatty degeneration of nephrocytes of the renal tubules of the proximal and distal nephron (dichloroethane) and hydropic degeneration of nephrocytes (carbon tetrachloride).

Acute hemoglobinuric nephrosis develops in case of poisoning with hemolytic poisons, intravascular hemolysis of another etiology. Characteristic are pigment casts in the lumen of the renal tubules and damage to the epithelium of the renal tubules due to reabsorption of hemoglobin.

Acute myoglobinuric nephrosis develops with positional compression syndrome (myorenal syndrome). In this case, myoglobin casts are found in the tubules.

Obstruction of the renal tubules was observed in the early years of widespread use of sulfonamides.

One of the early signs of toxic nephropathy is a decrease in diuresis to oliguria and anuria. Urine density increases to 1024-1052, proteinuria - up to 33 g/l, azotemia, glomerular filtration and tubular reabsorption decrease.

Patients develop pain in the lumbar region, associated with increasing interstitial edema of the kidneys, and puffiness of the face. The following three degrees of severity of toxic nephropathy are identified:

1) mild, characterized by the manifestation of moderate and quickly passing (1-3 weeks) changes in the qualitative and morphological composition of urine and kidney function: glomerular filtration (Ј76.6 ± 2.8 ml/min) and renal plasma flow (Ј552.2 ± 13. 6 ml/min) with preserved concentration and nitrogen excretion functions of the kidneys;

2) medium, characterized by more pronounced and persistent (up to 2-3 weeks) changes in the qualitative and morphological composition of urine and accompanied by a noticeable decrease in glomerular filtration (Ј60.7 ± 2.8 ml/min), tubular reabsorption (Ј98.2 ± 0.1%) and renal plasma flow (Ј467.8 ± 20.2 ml/min);

3) severe, characterized by acute renal failure syndrome, characterized by pronounced symptoms of oliguria, azotemia, creatininemia, accompanied by a sharp decrease in glomerular filtration (Ј22.8 ± 4.8 ml/min), inhibition of reabsorption (Ј88.9 ± 1.8%), a significant decrease in renal plasma flow (Ј131.6 ± 14.4 ml/min).

Diagnosis is based on clinical picture, observations of diuresis and data laboratory research(acid-base composition, plasma electrolytes, nitrogen metabolism indicators).

In case of acute poisoning, in addition to shock therapy, measures are taken to remove poison from the body, such as gastric lavage, forced diuresis with alkalization, early hemodialysis, detoxification hemosorption, hemofiltration, peritoneal dialysis, plasmapheresis (for massive intravascular hemolysis and myoglobinuria). The use of these measures in the early period of acute poisoning with nephrotoxic poisons makes it possible to remove these substances from the body and prevent kidney damage.

Gastrointestinal tract syndrome

Often found in acute poisoning in the form of vomiting, esophageal-gastric bleeding and toxic gastroenteritis, stomatitis, burns of the digestive tract, ulcerative (excretory) colitis, pancreatitis. Acute toxic gastroenteritis is dangerous primarily by the development of water-salt dehydration (chlorhydropenia). The causes of toxic diarrhea can be colchicine, mushrooms, trichlorethylene, digitalis, paraquat, lithium salts, anticholinesterase substances, salts of heavy metals (arsenic, mercury), iron, thyroid hormones.

The syndrome of trophic disorders (bullous dermatitis, necrotizing dermatomyositis) complicates severe poisoning with psychotropic drugs. Trophic disorders occur in places where solid parts of the body (bone protrusions, etc.) come into contact with the underlying surface and with each other.

Myorenal syndrome develops as a result of impaired renal function due to muscle damage during a prolonged immobile position of the patient in a comatose state (positional compression syndrome of soft tissues), as well as due to direct damage to myocytes during poisoning with certain poisons (heroin, cocaine, ecstasy, doxylamine, phenothiazines, etc.), as well as with malignant hyperthermia, convulsive attacks leading to rhabdomyolysis.

The etiological factors causing the development of hemolytic processes are various chemicals (hydrogen arsenous, phenylhydrazine, copper sulfate, bertholet's salt), medications (quinine, phenacetin, sulfonamides, etc.) and some plants (alpine violet, lupium, gorse, some legumes and etc.). The most common cause of toxic hemolysis is acetic acid poisoning. An objective criterion for the severity of the hemolytic process is the content of free hemoglobin in the blood plasma:

1) mild degree is characterized by the content of free hemoglobin in the blood up to 5 g/l;

2) average degree - 5-10 g/l;

3) severe degree - more than 10 g/l.

Hemoglobinuria is usually observed when the concentration of free hemoglobin in the blood is 0.8-1.0 g/l. Urine becomes reddish-brown in color.

Metabolic acidosis. Acidosis can be detected in all cases of circulatory disorders. It is caused by the loss of bicarbonates during diarrhea (poisoning with mushrooms, colchicine, salts of heavy metals, trichlorethylene, etc.); violation of acid excretion in renal failure (poisoning with lithium salts, heavy metals, paraquat, etc.); exogenous intake of acids (in case of poisoning with cauterizing poisons, ammonium chloride, etc.).

Acidosis is associated with anionic disturbances indirectly during convulsions, collapse, tissue hypoxia (cyanides), and other mechanisms in poisoning with chloroquine, depakine, carbon monoxide, theophylline, etc. The most significant metabolic changes are characteristic of poisoning with methanol, ethylene glycol, isopropyl alcohol, butyl alcohol, ethanol , salicylates, paraldehyde. If acidosis cannot be eliminated by the introduction of sodium bicarbonate, then the use of extracorporeal purification methods is necessary.

Metabolic alkalosis may be caused by loss of acids during vomiting, aspiration of gastric contents; loss of acids in the urine during poisoning with thiazide and loop diuretics, antibiotics, mineralocorticoids; excess supply of bases.

Hypokalemia may develop as a result of an increase in intracellular potassium concentration (in case of poisoning with theophylline, chloroquine, b-adrenergic agonists, insulin, barium salts); renal losses (in case of poisoning with cocaine, mineralocorticoids, diuretics); losses through the gastrointestinal tract (in case of poisoning with digitalis, colchicine, trichlorethylene, mushrooms, antibiotics). Hypokalemia can lead to cardiac arrhythmias, paresthesia, and quadriparesis.

Hyperkalemia develops with rhabdomyolysis, increased intake of potassium salts (potassium chloride, benzylpenicillin potassium salt, etc.), impaired excretion of potassium by the kidneys (potassium-sparing diuretics, trireside K, cyclosporine, non-steroidal anti-inflammatory drugs, lithium salts), release of potassium from the cell (in case of b- blockers, digitalis, etc.), with anuria and oliguria.

Hyponatremia may be the result of increased sodium excretion or a consequence of hemodilution. Dilutional hyponatremia is found in cases of water poisoning (drinking a large amount of water in a short period of time). Significant hyponatremia, accompanied by disturbances of consciousness, is possible when taking large amounts of beer, which has osmodiuretic properties. A large number of medications have the ability to reduce the activity of antidiuretic hormone (amitriptyline, biguanides,

Collapse

Cerebral edema due to alcoholism is a toxic lesion in which excess fluid accumulates in the brain tissue. This complication often occurs due to alcohol intoxication in the body, especially if this condition is chronic.

Concept of alcoholic cerebral edema

Excess fluid accumulates in cells and intercellular space. Therefore, with this pathology, the brain increases in size. A clear sign of edema is increased intracranial pressure.

Swelling for the body is a normal reaction to any damage, but this does not apply to the brain. Since this organ is located in the skull, that is, in a closed space. The cranial bones will not expand under the influence of enlarged tissue, so the brain structures are compressed.

Ethyl alcohol enters the brain within a few minutes after consumption. As a result of the harmful effects of this substance, metabolic processes in neurons are disrupted and their functioning is disrupted. And then they die, and this place is replaced by liquid.

Causes

The main reason why alcoholic cerebral edema occurs is severe intoxication of the body due to alcohol poisoning. But provoking factors may also be:

Manifestations of allergic reactions in the form of anaphylactic shock. Quite often, this reaction occurs due to alcoholism, since alcoholic drinks are strong allergens.
Acute cerebral circulatory disorders - stroke. This is a pathology that often occurs in people who abuse alcohol.
Injuries, skull fractures, brain contusions and the formation of post-traumatic hematomas. People often receive such injuries while intoxicated, as coordination of movements is impaired.
Development of decompensated renal, hepatic and/or heart failure. These target organs are primarily affected by excessive alcohol consumption.

Severe intoxication of the body due to alcohol poisoning is the main cause of cerebral edema

Symptoms and signs

The symptoms of this disease are similar to cerebral edema due to other causes. Namely, this condition is characterized by:

Headache that does not go away after taking pain medication.
Attacks of nausea with vomiting.
Visual impairment. This is due to changes in the fundus of the eye.
Decreased sensitivity of the face and neck.
Impaired consciousness.
Changes in the amplitude of respiratory movements, there may be an increase or decrease.
Tachycardia.
Periodic convulsions.

Additionally, there are signs by which you can recognize cerebral edema in alcoholism. The most pronounced thing is the human physique. At the same time, he has thin limbs and a large belly. The volume of the face also increases due to tissue swelling. Hematomas appear on the skin and it peels off.

Note! Disturbances of consciousness are especially visible in an alcoholic with edema. In this case, frequent fainting and a state of stupor may occur. There is already pronounced partial or complete amnesia.

Treatment

If cerebral edema is suspected and alcohol dependence is confirmed in a person, he is immediately prescribed a characteristic diagnosis. Instrumental diagnostic methods that have proven their effectiveness:

Electroencephalography. In this case, the electrical activity of the cerebral cortex is recorded using special sensors.
Pneumoencephalography. This study helps to assess the condition of the ventricles of the brain and their fullness.
Computed tomography is a modern method that allows you to visualize an organ and read all its parameters.

If you experience all or some of the listed symptoms, you should seek medical help. Because if this is not done on time, then death will occur as a complication of the pathology.

The goal of drug treatment in the initial stages is to relieve swelling and treatment aimed at relieving alcohol intoxication. Treatment of alcoholic cerebral edema takes place only in a hospital and the recovery period should also be under the supervision of doctors. In addition, treatment for alcohol dependence should take place in a special institution, since otherwise the remission will not be long.

To relieve cerebral edema, infusions of solutions containing Mannitol, Furomsemide or Dexamethasone are first prescribed. Additionally, medications may be prescribed in the form of tablets - Prednisolone, Betaspan or Eufillin.

Subsequently, the patient is prescribed drugs from the group of corticosteroids and barbiturates. They help inhibit the development of edema and prevent seizures. This means that the restoration of the blood circulation process occurs faster. An alcoholic must also take medications that affect blood quality and vascular tone. These include Cavinton.

Metabolic processes in neurons are restored thanks to nootropics. This is Piracetam, Pantogram. And cell membranes return to stabilization if complex therapy includes Troxevasin or Dicynone.

In order for the brain to begin functioning normally, it must be additionally saturated with oxygen. This requires oxygen therapy, in which oxygen is supplied to the body in the form of inhalations.

Sometimes surgical interventions are also necessary. Namely, a catheter is placed through which excess fluid is pumped out from the ventricles. This method called ventriculotomy. A craniotomy can also be performed, during which a bone fragment is removed.

In parallel with relieving swelling, doctors prescribe therapy to treat alcohol dependence. To do this, the first few days alcohol is removed from the human body. Drugs for detoxification are selected individually, as they must be combined with the main therapy for edema. Drugs that reduce craving for alcohol are:

Disulfiram;
Esperal;
Teturam.

Consequences and complications

The most common and severe complications of toxic cerebral edema in alcoholism are coma and death. This is due to the fact that the swelling blocks access to the brain tissue, which is why oxygen does not enter the cells. According to statistics, death occurs often, as an alcoholic loses criticism of himself and everything around him. Therefore, it is rarely possible to treat it in time.

Another complication of cerebral edema is paralysis of the body. This pathological condition occurs due to the death of neurons and high intracranial pressure. This leads to disability of the patient, which significantly complicates his life.

Attention! When the brain edema, the organ structures that are responsible for the rhythm and maintenance of breathing and other centers are compressed.

Even with timely treatment of cerebral edema, its consequences will last a lifetime. Since compression of organ structures and cell death cannot pass without leaving a trace. Therefore, a person will regularly experience headaches, sleep disturbances, psycho-emotional disorders (depressive states), and motor dysfunction.

Prevention

Prevention of cerebral edema is a complete abstinence from alcoholic beverages. You also need to undergo preventive examinations for diseases of the heart, liver, and kidneys. For the same reason, you need to constantly monitor your blood pressure.

For the manifestation of cerebral edema, it is not necessary to drink only strong drinks; for this, it is enough to regularly drink beer in large quantities or other drinks. Therefore, it is important to give up all bad habits.

Another way to prevent cerebral edema is to use various factors to protect the head, which will help protect it from injury.

Conclusion

Alcoholism is a disease that provokes a large number of complications in the body. Brain edema is one of them. The symptoms of this pathology are pronounced, so at the first manifestations you need to seek medical help. But of course, a person must stop drinking alcohol forever. Therefore, it is better for an alcoholic to undergo complex therapy, which is carried out in a rehabilitation center.

←Previous article Next article →

Brain swelling after alcohol. Brain swelling from alcohol