Management of vasogenic edema in patients with primary and metastatic brain tumors
- Jan Drappatz, MD
Jan Drappatz, MD
- Associate Director
- Adult Neuro-Oncology Program
- Associate Professor
- Departments of Neurology and Medicine
- University of Pittsburgh
- Patrick Y Wen, MD
Patrick Y Wen, MD
- Section Editor — Neurooncology
- Professor of Neurology
- Harvard Medical School
The vasogenic edema that surrounds many brain tumors contributes significantly to morbidity. This edema results from disruption of the blood brain barrier, allowing protein-rich fluid to accumulate in the extracellular space .
The pathogenesis of peritumoral vasogenic edema and the use of glucocorticoids are reviewed here. The acute treatment of elevated intracranial pressure (ICP) is discussed elsewhere. (See "Evaluation and management of elevated intracranial pressure in adults", section on 'General management' and "Evaluation and management of elevated intracranial pressure in adults", section on 'Specific therapies'.)
Tumor-related disruption in the blood brain barrier is caused by two major mechanisms:
●The absence of tight endothelial cell junctions in tumor blood vessels. These vessels develop in response to angiogenic factors such as VEGF  and basic fibroblast growth factor (bFGF, FGF - 2) .
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