Treatment of cerebral edema: present and future

Currently, only symptomatic treatment is applied to patients with cerebral edema. It is aimed at correcting intracranial hypertension as a complication of the already formed cerebral edema. Targeted pathogenetic treatment capable of affecting various molecular processes during the formation of cerebral edema is considered as a promising area. The review article presents currently available symptomatic treatments. The emphasis is placed on the hyperosmolar therapy most often used in the treatment of elevated intracranial pressure. Possible side effects of this therapy and ways to minimize them are described. Future vectors of treatment based on ultrastructural studies of the development of cerebral edema are discussed. Advances in molecular biology have made it possible not only to identify possible targets, but also to try to influence them with well-known drugs that were previously used for another purpose. In this regard, much attention in the literature is paid to the antidiabetic drug glibenclamide. The use of small doses of this drug has shown antiedematous effect at the early stages of edema formation, not only in experimental animals, but also in clinical practice. We presented the generalized data on the directions of treatment of cerebral edema both at the present time and those planned in the future in the form of a scheme.

cerebral edema, methods of treatment of intracranial hypertension, hyperosmolar therapy, molecules for targeted therapy of cerebral edema, antiedematous effect of glibenclamide