When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply
A) Impaired blood–brain barrier that allows water/proteins to leave vessels and go into the interstitial space
B) Mainly allows edema to form in the white mater of the brain
C) May cause herniation by displacing a cerebral hemisphere
D) Causes ischemia to build up lactic acid due to anaerobic metabolism
E) Allows cells to increase volume to the point of rupture, damaging neighboring cells
Ans: D, E
Feedback:
Cytotoxic edema involves an increase in intracellular fluid. Ischemia results in the inadequate removal of anaerobic metabolic end products such as lactic acid, producing extracellular acidosis. If blood flow is reduced to low levels for extended periods or to extremely low levels for a few minutes, cellular edema can cause the cell membrane to rupture, allowing the escape of intracellular contents into the surrounding extracellular fluid. This leads to damage of neighboring cells. Vasogenic edema occurs with conditions that impair the function of the blood–brain barrier and allow transfer of water and proteins from the vascular into the interstitial space. It occurs primarily in the white matter of the brain, possibly because the white matter is more compliant than the gray matter. Vasogenic edema can result in displacement of a cerebral hemisphere and various types of brain herniation.
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