How can neonatal cerebral edema be treated?

When a baby is born in the family, it will bring infinite joy to the family. In the process of taking care of the baby, parents should carefully observe the baby's reactions. When the baby feels uncomfortable, he can only express it with body language. If the baby has convulsions, coma, vomiting and high blood pressure, the baby should be taken to the hospital for treatment in time. These phenomena are likely to be caused by cerebral edema.

Treatment of neonatal cerebral edema

1. General treatment.

Keep quiet and rest, ensure airway patency and oxygen supply, maintain blood pressure, blood sugar, and blood electrolytes within normal range, and correct acidosis in time.

2. Intensive care.

Carry out cardiopulmonary, blood pressure, intracranial pressure and EEG monitoring, and closely observe body temperature, respiration, consciousness, eye movement, pupil size, anterior fontanelle and the presence of early convulsions. Maintain blood gases and pH within normal range. When heart failure and shock occur, timely treatment is required.

3. Maintain calories and limit fluid intake appropriately.

Generally, the amount of fluid should be limited to 60-80 ml/kg per mouthful within 3 days after birth, and the infusion rate should be 4 ml/kg per hour. Glucose intake is 10-20 g/kg per day to maintain blood sugar at 4.2-5.6 mmol/L, and intravenous high nutrition is given when necessary. Sodium bicarbonate should be used with caution to avoid aggravating cerebral edema.

4. Anti-cerebral edema treatment. Comprehensive treatment can be carried out with drugs such as mannitol, furosemide and dexamethasone.

5. Artificial sub-hibernation therapy. For patients with acute cerebral edema accompanied by fever, the body temperature should be lowered to 35-37℃ within 2-3 hours, and sub-hibernation should be maintained for about 12 hours. The hibernation drugs should be removed and the body should be gradually warmed up.

6. Oxygen free radical scavenger. Vitamin E, vitamin C, superoxide dismutase, catalase, etc. can be used

Symptoms of cerebral edema

1. Symptoms of brain damage

Common symptoms include worsening of epilepsy and paralysis symptoms, or the expansion of the water quality range, affecting the language and motor center, thus causing motor aphasia. After brain injury, if symptoms gradually worsen, cerebral edema should be considered. Diffuse cerebral edema may continue to expand to the whole brain due to failure to control localized cerebral edema, or it may be diffuse cerebral edema from the beginning.

2. Symptoms of increased intracranial pressure

Symptoms include headache, increased vomiting, restlessness, drowsiness and even coma. Fundus examination may reveal papilledema. Early changes in vital signs, slowed pulse and breathing, and compensatory symptoms of increased blood pressure, such as cerebral edema and increased intracranial pressure, may lead to brain herniation if symptoms continue to worsen.

3. Other symptoms

Cerebral edema affecting the frontal lobe, temporal lobe, and anterior thalamus can cause mental disorders. In severe cases, patients may suffer from fever, confusion, and coma. Increased intracranial pressure can also cause psychiatric symptoms. Sometimes the body temperature rises moderately, and cerebral edema involves the hypothalamus, which can cause symptoms of hypothalamic damage.