Biochemical Aspects of Cerebral Edema

  • A. Baethmann
  • W. Oettinger
  • W. Rothenfusser
  • R. Geiger


Biochemical research on cerebral edema has certainly advanced the understanding of this complex condition. Biochemistry has been of great use in defining the different manifestations of this entity. Chemical investigations are probably more suitable than other methods to quantify the amount of edema in brain tissue, and to measure the effect of edema treatment. Since the pioneering work of Stewart-Wallace, Elliott and Jasper, and Pappius and co-workers, considerable material on the chemistry and biochemistry of brain edema has been published, supporting the existence of the two major prototypes described by Klatzo (10, 18, 30, 31, 43). Representative studies concern, for example: (1) the chemical composition of edematous tissue, (2) the edema fluid proper, (3) the distribution of edema in the tissue, and (4) the metabolic response of brain tissue to edema. Furthermore, investigations on chemical tissue or plasma factors promoting edema formation and persistence may be included in this subject. Obviously, a discussion of this material cannot be comprehensive within the scope of this brief introduction. Instead, a few aspects considered particularly significant will be emphasized.


White Matter Cerebral Edema Biochemical Aspect Cold Injury Edema Fluid 
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  1. 1.
    Aleu, F. P., Katzman, R. and Terry, R. D.: Fine structure and electrolyte analyses of cerebral edema induced by alkyl tin intoxication. J. Neuropathol. Exp. Neurol. 22: 403–413, 1963.PubMedCrossRefGoogle Scholar
  2. 2.
    Baethmann, A. and van Harreveld, A.: Water and electrolyte distribution in gray matter rendered edematous with a metabolic inhibitor. J. Neuropathol. Exp. Neurol. 32: 407–423, 1973.Google Scholar
  3. 3.
    Baethmann, A., and Schmiedek, P.: Pathophysiology of cerebral edema: chemical aspects, in: Brain Edema, Cerebello-Pontine Angle Tumors, K. Schurmann, M. Brock, H. J. Reulen and D. Voth (eds), Advances in Neurosurger 1: 5–18, Springer, Berlin-Heidelberg-New York, 1973.CrossRefGoogle Scholar
  4. 4.
    Bingham, J. W., Paul, S. E. and Sastry, K. S. S.: Effects of cold injury on six enzymes in rat brain. Arch. Neurol. 21: 649–660, 1969.PubMedCrossRefGoogle Scholar
  5. 5.
    Blümel, G.: Über die mögliche Beteiligung des Kinin-systems bei einem chirurgischen Zustandsbild, in: Haberland, G. L., and Matis, P. (eds), Neue Aspekte der Trasylol Therapie, 3: 125–130, F. X. Schattauer, Stuttgart-New York, 1969.Google Scholar
  6. 6.
    Bulle, P. K.: Effects of reserpine and chlorpromazine in prevention of cerebral edema and reversible cell damage. Proc. Soc. Exp. Biol. Med. 94: 553–556, 1957.PubMedGoogle Scholar
  7. 7.
    Ciasen, R. A., Sky-Peck, K. H., Pandolfi, S., Laing, I. and Hass, G. M.: The chemistry of isolated edema fluid in experimental cerebral injury, in: Klatzo, I. and Seitelberger, F. (eds), Brain Edema, pp. 536–553, Springer, Wien, 1967.Google Scholar
  8. 8.
    Costa, J. L., Ito, U., Spatz, M., Klatzo, I. and Demirjian, C.: 5-Hydroxytryptamine accumulation in cerebrovascular injury. Nature 248: 2444: 135–136, 1974.PubMedCrossRefGoogle Scholar
  9. 9.
    Demopoulos, H. B., Milvy, P., Kakari, S. and Ransohoff, J.: Molecular aspects of membrane structure in cerebral edema, in: Reulen, H. J. and Schurmann, K. (eds), Steroids and Brain Edema, pp. 29–39, Springer, Berlin-Heidelberg-New York, 1972.CrossRefGoogle Scholar
  10. 10.
    Elliott, K. A. C. and Jasper, H.: Measurement of experimentally induced brain swelling and shrinkage. Amer. J. Physiol. 157: 122–129, 1949.PubMedGoogle Scholar
  11. 11.
    Frey, E. X., Werle, E. and Kraut, H.: Das Kallikrein-Kinin System und seine Inhibitoren, F. Enke, Stuttgart 1968.Google Scholar
  12. 12.
    Frei, H. J., Wallenfang, T., Poll, W., Reulen, H. J., Schubert, R. and Brock, M.: Regional cerebral blood flow and regional metabolism in cold induced edema. Acta Neurochirurg. 29: 15–28, 1973.CrossRefGoogle Scholar
  13. 13.
    Herzog, I., Levy, W. A. and Scheiberg, L. C.: Biochemical and morphologic studies of cerebral edema associated with intracerebral tumors in rabbits. J. Neuropathol. Exp. Neurol. 24: 244–255, 1965.PubMedCrossRefGoogle Scholar
  14. 14.
    Hill, K. R. and Joyner, R. W.: Computerized X-ray tomography. Sci. Prog. (Oxford) 62: 237–262, 1975.Google Scholar
  15. 15.
    Hjelm, M., Overgaard, J., Lassen, N. A. and Tweed, W. A.: Brain tissue lactacidosis of hyperemic regions around brain tumors, in: Harper, A. M., Jennett, W. B., Miller, J. D. and Rowan, J. O. (eds), Blood Flow Metabolism in the Brain, pp. 1341–1342, Churchill Livingston, Edinburgh, 1975.Google Scholar
  16. 16.
    Jonsson, H. T. and Daniell, H. B.: Altered levels of PGF in cat spinal cord tissue following traumatic injury. Prostaglandins 11: 51–61, 1976.PubMedCrossRefGoogle Scholar
  17. 17.
    Khattab, F. I.: Alterations in acid phosphatase bodies (lysosomes) in cat motoneurons after asphyxiation of the spinal cord. Exp. Neurol. 18: 133–140, 1967.PubMedCrossRefGoogle Scholar
  18. 18.
    Klatzo, I.: Neuropathological aspects of brain edema. J. Neuropathol. Exp. Neurol. 26: 1–14, 1967.PubMedCrossRefGoogle Scholar
  19. 19.
    Klatzo, I.: Pathophysiology of brain edema: pathological aspects in: Schurmann, K., Brock, M., Reulen, H. J. and Voth, D. (eds), Brain Edema, Cerebellopontine Angle Tumors, Advances in Neurosurgery, 1: 1–4, Springer, Berlin-Heidelberg-New York, 1973.CrossRefGoogle Scholar
  20. 20.
    Mann, K., Geiger, R. and Werle, E.: A sensitive kinin liberating assay for kininogenase in rat urine, isolated glomeruli and tubules of rat kidney, in: Sicuteri, F., Back, N. and Haberland, G. I. (eds), Kinins: Pharmacodynamics and Biological Roles, pp. 65–73, Plenum, New York, 1973.Google Scholar
  21. 21.
    Mcllwain, H. and Bachelard, H. S.: Biochemistry and the Central Nervous System, 4th ed., p. 309, Churchill Livingston, Edinburgh, 1971.Google Scholar
  22. 22.
    Merils, J. K.: The effect of changes in the calcium content of the cerebrospinal fluid on spinal reflex activity in the dog. Amer. J. Physiol. 131: 67–72, 1940.Google Scholar
  23. 23.
    Misra, S. S., Singh, K. S. P. and Bhargava, K. P.: Estimation of 5-hydroxytryptamine (5-HT) level in cerebrospinal fluid of patients with intracranial or spinal lesions. J. Neurol. Neurosurg. Psychiatry 30: 163–165, 1967.PubMedCrossRefGoogle Scholar
  24. 24.
    Naftchi, N. E., Demeny, M. , de Crescito, V., Tomasula, J. J., Flamm, E. S. and Campbell, J. B.: Biogenic amine concentrations in traumatized spinal cords of cats. Effect of drug therapy. J. Neurosurg. 40: 52–57, 1974.PubMedCrossRefGoogle Scholar
  25. 25.
    Oettinger, W., Lanksch, W. and Baethmann, A.: The threshold of brain edema recognition by computerized tomography, in: Lanksch, W. and Kazner, E. (eds), Cranial Computerized Tomography, pp. 356–359, Springer, Berlin-Heidelberg-New York, 1976.CrossRefGoogle Scholar
  26. 26.
    Oettinger, W., Baethmann, A., Rothenfusser, W., Geiger, R. and Mann, K.: Tissue and plasma factors in cerebral edema, in: Pappius, H. M. and Feindel, W. (eds), Dynamics of Brain Edema, pp. 161–163, Springer, Berlin-Heidelberg-New York, 1976.CrossRefGoogle Scholar
  27. 27.
    Ortega, B. D., Demopoulos, H. B. and Ransohoff, J.: Effects of antioxidants on experimental cold-induced cerebral edema, in: Reulen, H. J. and Schurmann, K. (eds), Steroids and Brain Edema, pp. 167–175, Springer, Berlin-Heidelberg-New York, 1972.CrossRefGoogle Scholar
  28. 28.
    Osterholm, J. L., Bell, J., Meyer, R. and Pyenson, J.: Experimental effects of free serotonin on the brain and its relation to brain injury. Parts I–III, J. Neurosurg. 31: 408–421, 1969.PubMedCrossRefGoogle Scholar
  29. 29.
    Osterholm, J. L.: Noradrenergic mediation of traumatic spinal cord autodestruction. Life Sci. 14: 1363–1384, 1974.PubMedCrossRefGoogle Scholar
  30. 30.
    Pappius, H. M. and Gulati, D. R.: Water and electrolyte content of cerebral tissues in experimentally induced edema. Acta Neuropathol. 2: 461–480, 1963.CrossRefGoogle Scholar
  31. 31.
    Pappius, H. M.: Fundamental aspects of brain edema, in: Vinken, P. J. and Bruyn, G. W. (eds), Handbook of Clinical Neurology, Vol. 16, Tumors of the Brain and Skull, Part I, pp. 167–185, North Holland Publ. Co., Amsterdam, New York, 1974.Google Scholar
  32. 32.
    Pappius, H. M. and Wolfe, L. S.: Some further studies on vasogenic edema, in: Pappius, H. M. and Feindel, W. (eds), Dynamics of Brain Edema, pp. 138–143, Springer, Berlin-Heidelberg-New York, 1976.CrossRefGoogle Scholar
  33. 33.
    Pausecu, E., Lugojan, R. and Pausescu, M.: Cerebral catecholamine and serotonin metabolism in post-hypo-thermic brain edema. Brain 93: 31–36, 1970.CrossRefGoogle Scholar
  34. 34.
    Porta, M., Bareggi, S. R., Collice, M., Assael, B. M., Selenati, A., Calderini, G., Rossando, M. and Morselli, P. L.: Homovanillic acid and 5-hydroxyindole-acetic acid in the CSF of patients after a severe head injury. Eur. Neurol. 13: 545–554, 1975.PubMedCrossRefGoogle Scholar
  35. 35.
    Rasmussen, L. E. and Klatzo, I.: Protein and enzyme changes in cold injury edema. Acta Neuropathol. 13: 12–28, 1969.PubMedCrossRefGoogle Scholar
  36. 36.
    Reulen, H. J., Hoffmann, H. F. and Baethmann, A.: Die Beeinflussung des experimentellen traumatischen Hirnödems bei der Ratte mit einer Nikotinsauretheo-phyllin-Verbindung. Zschr. ges. exp. Med. 138: 246–256, 1964.PubMedCrossRefGoogle Scholar
  37. 37.
    Reulen, A. M. and Baethmann, A.: Das Dinitrophenol-ödem. Ein Modell zur Pathophysiologie des Hirnödems. Klin. Wschr. 45: 149–154, 1967.PubMedCrossRefGoogle Scholar
  38. 38.
    Robert, A. M. and Godeau, G.: Action of proteolytic and glycolytic enzymes on the permeability of the blood-brain barrier. Biomedicine 21: 36–39, 1974.PubMedGoogle Scholar
  39. 39.
    Sachs, E.: Acetylcholine and serotonin in the spinal fluid. J. Neurosurg. 14: 22–27, 1957.PubMedCrossRefGoogle Scholar
  40. 40.
    Sato, K., Jamaguchi, M., Mullan, S., Evans, J. P. and Ishii, S.: Brain edema. A study of biochemical and structural alterations. Arch. Neurol. 21: 413–424, 1969.PubMedCrossRefGoogle Scholar
  41. 41.
    Schmiedek, P., Baethmann, A., Sippel, G., Oettinger, W., Enzenbach, R., Marguth, F. and Brendel, W.: Energy state and glycolysis in human cerebral edema. The application of a new freeze-stop technique.J. Neurosurg. 40: 351–364, 1974.CrossRefGoogle Scholar
  42. 42.
    Sicuteri, F., Fanciullacci, M., Bavazzano, A., Franchi, G. and Del Bianco, P. L.: Kinins and intracranial hemorrhages. Angiology 21: 193–210, 1970.PubMedCrossRefGoogle Scholar
  43. 43.
    Stewart-Wallace, A. M.: A biochemical study of cerebral tissue and of changes in cerebral edema. Brain 62: 426–438.Google Scholar
  44. 44.
    Suzuki, O. and Yagi, K.: Formation of lipoperoxide in brain edema induced by cold injury. Experientia 30: 248, 1974.PubMedCrossRefGoogle Scholar
  45. 45.
    Trubatch, J. and van Harreveld, A.: Spread of ionto-phoretically injected ions in a tissue. J. theoret. Biol. 36: 355–366, 1972.CrossRefGoogle Scholar
  46. 46.
    Tzonos, T. and Rana, B.: Die Wirkung von Proteinasen und Fibrinolyse-Inhibitoren auf das experimentalle Hirnödem. Zschr. Neurol. 205: 61–70, 1973.CrossRefGoogle Scholar
  47. 47.
    van Harreveld, A. and Fifkova, E.: Light- and electron-microscopic changes in central nervous tissue after electrophoretic injection of glutamate. Exp. Molec. Pathol. 15: 61–81, 1971CrossRefGoogle Scholar
  48. 48.
    van Harreveld, A. and Fifkova, E.: Effects of glutamate and other amino acids on the retina. J. Neuro-chem. 18: 2145–2154, 1971.Google Scholar
  49. 49.
    Welch, K. M. A., Meyer, J. S., Teraura, T., Hashi, K. and Shinmaru, S.: Ischemic anoxia and cerebral serotonin levels. J. Neurol. Sci. 16: 85–92, 1972.PubMedCrossRefGoogle Scholar
  50. 50.
    Westergaard, E.: Enhanced vesicular transport of exogenous peroxidase across cerebral vessels, induced by serotonin. Acta Neuropathol. 32: 27–42, 1975.PubMedCrossRefGoogle Scholar
  51. 51.
    Yates, A. J., Thelmo, W. and Pappius, H. M.: Postmortem changes in the chemistry and histology of normal and edematous brains. Amer. J. Pathol. 79: 555–564, 1975.Google Scholar

Copyright information

© Plenum Press, New York 1979

Authors and Affiliations

  • A. Baethmann
    • 1
  • W. Oettinger
    • 1
  • W. Rothenfusser
    • 1
  • R. Geiger
    • 1
  1. 1.Institute for Surgical Research, Department of SurgeryUniversity of MunichMunichW. Germany

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