Peritumoural brain oedema - Diagnosis and treatment approaches

Peritumoural brain oedema can aggravate the mass effect of rumours and lead to additional complications. The oedema associated with brain rumours is v asogenic in nature and is due to an increase in the permeability of the blo od-brain barrier, The cause of this increased permeability it not entirely clear but is likely to be associated with the production of various substan ces by tumours (such as oxygen free radicals), an inflammatory response and /or an effect on the central vasopressin system. The diagnosis of peritumoural brain oedema is assisted by the use of imagin g techniques such as computed tomography, and magnetic resonance imaging an d spectroscopy, The treatment of peritumoural oedema involves the use of glucocorticoids or osmotic dehydrating agents, such as mannitol and glycerol, and the avoidan ce of factors that increase intracranial pressure. Based on current knowled ge of the causes of peritumoural oedema, future strategies may include the use of agents with antioxidant properties [such as lazaroids (tirilazad)], corticotropin-releasing factor and vasopressin inhibitors.