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Diffuse Cerebral Edema, Swelling, MedPix™ : 1889 - Medical Image Database and Atlas
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More Like This ? Diffuse Cerebral Edema, Swelling
Topic 1889 - Created: 2001-05-05 16:53:33-04 - Modified: 2008-02-16 19:11:58-05
ACR Index: 1.2

Diffuse cerebral edema is among the most life-threatening of all cerebral insults with a mortality approaching 50%. Imaging findings may occur within hours after onset, but recognizable abnormalities may be delayed by 24 to 48 hours.

• Imaging:
The most reliable early sign is effacement of the cerebral (surface) sulci, suprasellar and perimesencephalic cisterns. The ventricles appear small or compressed.

• CT shows homogeneously decreased attenuation with loss of the gray-white differentiation. The cerebellum may appear relatively hyperdense compared to the the cerebral hemispheres - the "white cerebellum" sign. This is due to vascular (autoregulatory) events.

• The "reversal sign" is similar, with the cerebellum, thalamus, and brainstem retaining their normal density appearance in comparison to the darker edematous cerebral cortex.

Unilateral or bilateral cerebral edema may lead to brain displacement, accompanied by signs of herniation that are discussed on other topics at this site.

Comments and Reviews - This Topic has Comments

Diffuse cerebral brain swelling may mimic the appearance of a subarachnoid hemorrhage on CT images. [PubMed] [PubMed] [PubMed] Keeping this exception in mind, CT is otherwise very accurate for the diagnosis of subarachnoid hemorrhage (SAH). [PubMed] The value of LP in patients with negative CT has been studied. Some studies recommend LP ( [PubMed] ) while others question the value when CT is normal ( [PubMed] ).
Comments/Review from: James G. Smirniotopoulos, M.D.
(Click on Name for Reviewer Information)

Contributor Credits

Topic Author(s): Eric N. Kinn
Topic Submitted by: Eric N Kinn - Author Info
Affiliation: Naval Medical Center San Diego
Topic approved by: James G. Smirniotopoulos, M.D. - Editor Info
Affiliation: Uniformed Services University

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