Cytotoxisch oedeem: Pathofysiologie

Cytotoxic edema arises from failure of the sodium-potassium pump in brain cells, including neurons and glial cells.

This pump maintains ion balance by actively transporting sodium ions out of the cell and potassium ions into the cell.

It requires energy from adenosine triphosphate, or ATP, which is generated in the mitochondria.

In conditions such as ischemia or hypoxia, ATP production falls, leading to pump failure.

When the sodium-potassium pump stops working, sodium accumulates inside the cell. This buildup disrupts osmotic balance, pulling water into the cell and causing it to swell, a condition known as cytotoxic, or intracellular, edema.

As more cells swell, overall brain volume increases. With increased swelling, blood perfusion declines, worsening ischemic injury in a vicious cycle.

The expansion of brain tissue raises intracranial pressure, or ICP. If ICP rises too high, it can compress vital brain structures and cause fatal brain herniation.