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Pathology and new players in the pathogenesis of brain edema

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Abstract

Brain edema continues to be a major cause of mortality after diverse types of brain pathologies such as major cerebral infarcts, hemorrhages, trauma, infections and tumors. The classification of edema into vasogenic, cytotoxic, hydrocephalic and osmotic has stood the test of time although it is recognized that in most clinical situations there is a combination of different types of edema during the course of the disease. Basic information about the types of edema is provided for better understanding of the expression pattern of some of the newer molecules implicated in the pathogenesis of brain edema. These molecules include the aquaporins, matrix metalloproteinases and growth factors such as vascular endothelial growth factors A and B and the angiopoietins. The potential of these agents in the treatment of edema is discussed. Since many molecules are involved in the pathogenesis of brain edema, effective treatment cannot be achieved by a single agent but will require the administration of a “magic bullet” containing a variety of agents released at different times during the course of edema in order to be successful.

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Acknowledgments

This review is dedicated to Dr. Igor Klatzo, an experimental neuropathologist par excellence, an innovative thinker and friend who died on 5th May 2007. Work in the author’s laboratory is supported by the Heart and Stroke Foundation of Ontario, Grant 6003.

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  1. Department of Laboratory Medicine and Pathobiology, Banting Institute, University of Toronto, Rm 417, 100 College Street, Toronto, ON, M5G 1L5, Canada

    Sukriti Nag & Janet L. Manias

  2. Ottawa Health Research Institute, University of Ottawa, Ottawa, ON, Canada

    Duncan J. Stewart

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  1. Sukriti Nag
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  2. Janet L. Manias
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Correspondence to Sukriti Nag.

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Nag, S., Manias, J.L. & Stewart, D.J. Pathology and new players in the pathogenesis of brain edema. Acta Neuropathol 118, 197–217 (2009). https://doi.org/10.1007/s00401-009-0541-0

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