Edema Serebri

Edema Cerebri

Vasogenik Sitotoksik Interstisial Osmotik

Kasus tumor Infark/iskemi Hidrosefalus SIADH

kasus trauma
Vasogenic edema is defined as extracellular
accumulation of fluid resulting from
disruption of the blood-brain barrier
(BBB) and extravasations of serum proteins,
while

Cytotoxic edema is characterized by cell swelling

caused by intracellular accumulation of
fluid
 Edema Serebri Vasogenik dan Sitotoksik

Michinaga, S., & Koyama, Y. (2015). Pathogenesis of brain edema and investigation into anti-edema drugs. International journal of
molecular sciences, 16(5), 9949–9975. doi:10.3390/ijms16059949
 Edema Interstisial
Interstitial (hydrocephalic) edema occurs in the setting of increased
intraventricular pressures, which cause rupture of the
ventricular ependymal lining.

Cairannya berupa CSF dengan kadar protein yang

negligible.

Ho, M.-L., Rojas, R., & Eisenberg, R. L. (2012). Cerebral Edema. American Journal of Roentgenology,
199(3), W258–W273.doi:10.2214/ajr.11.8081
 Edema Osmotik
Osmotic cerebral edema results when solute concentrations
differ between the brain parenchyma and blood plasma

Contoh: intoksikasi air, hyponatremia, SIADH, ketoasidosis diabetik

Ho, M.-L., Rojas, R., & Eisenberg, R. L. (2012). Cerebral Edema. American Journal of Roentgenology,
199(3), W258–W273.doi:10.2214/ajr.11.8081
Vasogenic edema
Cytotoxic Edema
Edema Peningkatan Penurunan
Iskemia
Cerebri TIK CPP

target utama terapi edema cerebri adalah

mencegah iskemia.
Blood-Brain Barrier

Endotelnya Tidak ada

tidak celah
berfenestrasi intraselular

Memiliki
tight junction
interseluler
 Komponen Blood-
Brain Barrier
Struktur Fungsi
Endotel Mencegah zat memasuki rongga
kapiler interstisial otak
Mencegah protein keluar dari kapiler
(karena hanya ada sedikit vesikel
pinositik)
Tight gap Mencegah ion memasuki rongga
junction interstitial (karena tight gap junction
memiliki impedans elektrik yang kuat)
Podosit Membantu mempertahankan fungsi
astrosit BBB
Memberi support biokimiawi untuk
endotel
Siddiqi, J. 2017. Neurosurgical Intensive Care 2nd Ed.
Basement Mempertahankan integritas BBB New York: Thieme
membrane
 CSF
ventrikel
Rongga interseluler

Sel ependim

Blood-
Parenkim
Brain
otak Barrier
Tight
junction
Siddiqi, J. 2017.
Neurosurgical Intensive
Lumen kapiler Care 2nd Ed. New York:
Thieme
 CSF
ventrikel
Blood-
Tight junction
Sel epitel pleksus
CSF
koroid Barrier
Parenkim
otak
Sel endotel
berfenestrasi

Lumen kapiler Siddiqi, J. 2017.

Neurosurgical Intensive
Care 2nd Ed. New York:
Thieme