CSF-Electrolytes in Two Different Types of Metabolic Brain Edema

The significance of vasogenic brain edema is well understood for a variety of clinical conditions, while this is not true in the case of the cytotoxic form. A lack of knowledge on edema forming mechanisms, on the dynamics of edema development and edema resolution may still impede an appreciation of this type of brain edema. A number of mechanisms may cause the formation of cytotoxic brain edema. Compounds such as e.g. biogenic amines, metabolites (7, 10) etc. could be released into the extracellular compartment increasing the Na-permea-bility of the plasma membranes. Osmotic activity, which in the intra-cellular compartment is primarily bound becomes unbound by the process initiating brain edema or by concomitant derangements of the cellular energy metabolism, thus probably dramatically increasing the intracellular osmolarity. In both cases, intracellular swelling would ensue.