Side Effect: Brain swelling (Cerebral Edema)
What is Brain swelling (Cerebral Edema)?
- Swelling around the brain, also called cerebral edema, is a medical condition where there is an accumulation of fluid in the brain tissue due to a disruption of the blood-brain barrier.
- Brain swelling can cause increased pressure within the skull, also known as intracranial pressure.
- Brain swelling can be serious and usually requires immediate medical attention.
What does Brain swelling (Cerebral Edema) look like?
- The gold standard for diagnosing brain swelling is imaging with either a computed tomography (CT) scan or magnetic resonance imagining (MRI) of the brain.
- The appearance of brain swelling on imaging studies can vary depending on the cause and severity of the condition.
- In general, the brain tissue may appear swollen and compressed and there may be areas of abnormal enhancement or contrast uptake on the scan.
- Symptoms of brain swelling may include all or some of the following:
- headaches
- confusion
- seizures
- nausea and vomiting
Who gets Brain swelling (Cerebral Edema)?
Brain swelling can be caused by many factors including:
- traumatic brain injury
- stroke
- infection
- in patients with cancer, swelling around the brain can happen due to the presence of primary brain tumors or brain metastases
- radiation to the brain can also cause temporary brain swelling.
How to prevent Brain swelling (Cerebral Edema)
- Preventing brain swelling in patients with cancer involves addressing the underlying cause of the swelling before it has an opportunity to cause swelling
- In some cases, corticosteroids like dexamethasone (Decadron©) may be used to reduce inflammation in the brain and prevent further brain swelling.
- If a brain tumor is present, surgical resection of the lesion or radiation may be necessary to prevent swelling from getting worse.
How to treat Brain swelling (Cerebral Edema)
Treatment of brain swelling in patients with cancer may include:
- surgical resection of brain tumors if present
- radiation
- chemotherapy
- corticosteroids like dexamethasone (Decadron©) to reduce inflammation
- In patients with certain primary brain tumors, a vascular endothelial growth factor (VEGF) inhibitor called bevacizumab (Avastin©) may be used to reduce brain swelling.
- In patients who developed seizures due to brain swelling, antiseizure medications may be prescribed to prevent further seizures from occurring.
References
1. Nehring SM, Tadi P, Tenny S. Cerebral Edema. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
2. Giglio P, Gilbert MR. Neurologic complications of cancer and its treatment. Curr Oncol Rep. 2010;12(1):50-59.
3. Esquenazi Y, Lo VP, Lee K. Critical care management of cerebral edema in brain tumors. J Intensive Care Med. 2017;32(1):15-24.
4. Daou BJ, Palmateer G, Wilkinson DA, et al. Radiation-induced changes and cerebral edema following stereotactic radiosurgery for brain AVMs. Am J Neuroradiol. 2021;42(1):82-87.
5. Kostaras X, Cusano F, Kline GA, et al. Use of dexamethasone in patients with high-grade glioma: a clinical practice guideline. Curr Oncol. 2014;21(3):e493-e503.
6. Vogelbaum MA, Brown PD, Messersmith H, et al. Treatment for brain metastases: ASCO-SNO-ASTRO Guideline. J Clin Oncol. 2021;40;492-516.
7. Chang SM, Messersmith H, Ahluwalia M, et al. Anticonvulsant prophylaxis and steroid use in adults with metastatic brain tumors: ASCO and SNO endorsement of the congress of neurological surgeons guidelines. J Clin Oncol. 2019;37:1130-1135.
Created: May 3, 2024
Updated: May 3, 2024
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