Cerebral edema, swelling that occurs in mind, is a severe and probably deadly complication of stroke. New research, which was performed in mice and appeared in the journal Science, reveals for the first time that the glymphatic system—usually associated with the helpful task of waste removal—goes awry throughout a stroke and floods the brain, inflicting edema and drowning brain cells.
First observed by the Nedergaard laboratory in 2012, the glymphatic system involves a mesh that piggybacks on the brain’s blood circulation system and involves layers of plumbing, with the inner blood vessel enclosed by a ‘tube’ that transports cerebrospinal fluid (CSF).
While edema is a well-known result of stroke, there are restricted treatment options, and the severity of swelling in the brain relies upon the extent and location of the stroke.
Since the brain is fixed in the skull, it has little room to expand. If the swelling is extreme, it will possibly drive-in on vital structures such as the brainstem, which monitors the cardiovascular and respiratory systems, leading to death.
In severe cases and sometimes as a last resort, surgeons will remove part of the skull to alleviate the stress on the brain.
Prior to the findings of the new research, it has been assumed that the source of swelling was the result of fluid from the blood.
Ischemic stroke, the most common type of stroke, occurs when a vessel in the brain is chocked.
Denied vitamins and oxygen, brain cells turn into compromised and depolarize—often inside minutes of a stroke.
As the cells release energy, they trigger neighboring cells, making a domino effect that ends in an electrical flow that expands outward from the site of the stroke, referred to as spreading depolarization.