Skip to main content
WoMWeb of Medicine
SearchGraphHistory
Critical Care Medicine›Condition·Updated Apr 17, 2026·v1

Cerebral Edema

Cerebral edema is a critical secondary complication of brain injury characterized by fluid accumulation and increased intracranial pressure. Management focuses on osmotic gradients, surgical decompression, and strict metabolic control.

High Evidence267 references·1,109 words·5 min read·v1
Critical CareNeurologyNeurosurgeryIntracranial PressureBrain Herniation

Quick Reference

RxDrug of choiceMannitol (0.5–1.0 g/kg IV) or Hypertonic Saline (3% NaCl)
AltAlternativesDexamethasone (for tumors/HACE), Glyburide (investigational for stroke), Pentobarbital (refractory ICP)
⊘AvoidCorticosteroids in TBI or Ischemic Stroke; Hypotonic fluids (e.g., D5W, 0.45% NS)
DxTest of choiceNon-contrast Head CT (NCCT) for acute screening; MRI (DWI/ADC) for characterization
ScKey scoreMidline Shift (MLS) ≥ 5 mm; Glasgow Coma Scale (GCS)
→When to referGCS ≤ 8, midline shift ≥ 5 mm, signs of herniation, or refractory intracranial hypertension
Cerebral edema is a neurosurgical emergency; management requires a tiered approach of head elevation, osmotic therapy, and potentially decompressive surgery.
Cerebral edema is the pathological accumulation of excess fluid within the brain parenchyma, leading to increased brain volume and a life-threatening rise in [[intracranial pressure]] (ICP). It is never a primary disease but rather a secondary response to diverse insults, including [[traumatic brain injury]], [[ischemic stroke]], intracranial neoplasms, and metabolic derangements like [[hyponatremia]] or [[diabetic ketoacidosis]]. Because the brain is encased in the rigid skull, even small increases in volume can exhaust compensatory mechanisms, leading to mechanical compression of vital structures and [[brain herniation]].

Overview and Recommendations

Background

  • •Understand the primary pathophysiological classification: vasogenic edema involves (BBB) disruption allowing fluid leakage into the extracellular space (common in tumors), while cytotoxic edema involves cellular swelling due to ATP-pump failure (hallmark of ).
  • •Recognize the Monro-Kellie doctrine, which dictates that the sum of volumes of brain, cerebrospinal fluid (CSF), and blood is constant; once compensatory displacement of CSF and venous blood is exhausted, ICP rises precipitously.
  • •Identify Malignant Cerebral Edema (MCE) as a specific, high-mortality variant occurring in large-vessel ischemic strokes, typically defined by a midline shift of ≥5 mm on imaging within the first 72 hours.
  • •Note the role of specialized water channels like Aquaporin-4 (AQP4), which facilitates water movement into astrocytes during the acute phase of injury but may assist in fluid clearance during the recovery phase.
  • •Consider metabolic and environmental triggers, such as severe (sodium ≤ 125 mmol/L), pediatric , and high-altitude cerebral edema (HACE), which occurs typically at altitudes >2500 meters.
  • •Acknowledge the 'no-reflow phenomenon' (NRP), where microvascular reperfusion fails despite successful large-vessel recanalization in stroke, further predisposing the brain to inflammatory swelling.

Evaluation

  • •Suspect cerebral edema in any patient with a primary neurological insult who develops a declining (GCS) score, new focal deficits, or signs of autonomic instability.
  • •Examine for Cushing’s triad—hypertension, bradycardia, and irregular respirations—which is a late and ominous sign of impending .
  • •Perform a detailed pupillary exam; a fixed, dilated pupil suggests uncal herniation and compression of the third cranial nerve, requiring immediate intervention.
  • •Order a non-contrast head CT (NCCT) as the first-line diagnostic study to evaluate for sulcal effacement, loss of gray-white differentiation, and ventricular compression.
  • •Measure the midline shift (MLS) on CT; a shift of ≥5 mm is a definitive marker for malignant swelling and a high risk of clinical deterioration.
  • •Utilize MRI with Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) maps to differentiate between cytotoxic (low ADC) and vasogenic (high ADC) edema.
  • •Perform bedside ultrasound of the optic nerve sheath diameter (ONSD); a diameter >5.5–6.0 mm serves as a reliable non-invasive proxy for elevated ICP.
  • •Monitor serum sodium and osmolality frequently, especially in patients receiving hyperosmolar therapy, to identify 'non-responders' (sodium increase <5 mEq/L after a bolus).
  • •Rule out metabolic mimics by checking serum ammonia in patients with liver failure or suspected urea cycle disorders, as hyperammonemia drives astrocyte swelling.
  • •Assess for high-altitude retinopathy (HAR) in patients presenting with ataxia and altered mental status at elevation, as retinal hemorrhages often coexist with HACE.
  • •Evaluate for insular cortex involvement in acute stroke patients; insular infarction carries a nearly 3-fold increased risk for developing malignant edema.
  • •Monitor heart rate variability (HRV) in the ICU; decreased parasympathetic activity is associated with the expansion of perihematomal edema after .

Management

  • •Elevate the head of the bed to 30–45 degrees and maintain the neck in a neutral position to optimize venous outflow and reduce ICP.
  • •Administer Mannitol 20% at a dose of 0.5–1.0 g/kg IV over 20 minutes as a first-tier osmotic agent to create a gradient that draws fluid from the brain parenchyma.
  • •Utilize Hypertonic Saline (HTS) 3% as an alternative or adjunct; a 250 mL bolus or 3 mL/kg can be given, especially in patients with hypotension or those not responding to mannitol.
  • •Administer Dexamethasone 10 mg IV bolus followed by 4 mg every 6 hours for vasogenic edema associated with brain tumors or HACE; avoid steroids in TBI or ischemic stroke.
  • •Maintain normoxia and normocapnia; reserve aggressive hyperventilation (target PaCO2 30–35 mmHg) only as a temporary bridge for patients with active herniation.
  • •Insert an External Ventricular Drain (EVD) for both continuous ICP monitoring and therapeutic drainage of CSF in patients with GCS ≤8 or hydrocephalic edema.
  • •Initiate sedation with Propofol (5–50 mcg/kg/min) to reduce cerebral metabolic demand and prevent ICP spikes associated with agitation or ventilator dyssynchrony.
  • •Perform a decompressive hemicraniectomy in patients <60 years old with malignant MCA stroke who deteriorate despite medical therapy, ideally within 48 hours of onset.
  • •Manage pediatric DKA cautiously by initiating fluid resuscitation with isotonic saline and delaying insulin infusion (0.1 units/kg/hr) until after the first hour of fluids.
  • •Treat HACE with immediate descent of at least 500–1000 meters and supplemental oxygen; if descent is impossible, use a portable hyperbaric (Gamow) bag.
  • •Avoid the use of bicarbonate in DKA and thiazide diuretics in ICH, as both can exacerbate cerebral swelling through metabolic and osmotic shifts.
  • •Target a cerebral perfusion pressure (CPP) of 60–70 mmHg by utilizing vasopressors if necessary to maintain mean arterial pressure (MAP) in the face of high ICP.
  • •Consider Sulfonylureas (e.g., Glyburide) in the context of severe ischemic stroke to inhibit the SUR1-TRPM4 channel, which is a key driver of necrotic swelling.
  • •Monitor for rebound edema when tapering osmotic agents or steroids; tapers should be gradual over several days once ICP has stabilized.
  • •Refer for neurosurgical consultation immediately upon the discovery of midline shift ≥5 mm, obstructive hydrocephalus, or large-volume hematomas.
  • •Maintain strict normothermia; fever increases the cerebral metabolic rate and worsens BBB disruption, so utilize cooling blankets or intravascular cooling if needed.

Board Review — High Yield

  • •Monro-Kellie Doctrine — The skull is a rigid container; an increase in one component (brain, blood, CSF) must be compensated by a decrease in others or ICP will rise.
  • •Cytotoxic vs. Vasogenic — Cytotoxic is intracellular (stroke/ischemia); Vasogenic is extracellular (tumors/BBB breakdown).
  • •Cushing's Triad — Hypertension, bradycardia, and irregular respirations; indicates late-stage increased ICP and imminent herniation.
  • •Malignant MCA Stroke — Rapid swelling in large infarcts; decompressive hemicraniectomy reduces mortality if done within 48 hours in patients <60.
  • •HACE Hallmark — High-altitude cerebral edema typically involves vasogenic swelling of the corpus callosum.
  • •DKA Risk — In pediatric DKA, rapid fluid administration and early insulin/bicarbonate increase the risk of fatal cerebral edema.
  • •Optic Nerve Sheath Diameter — A non-invasive ultrasound measurement >5.5 mm suggests elevated ICP.
  • •Aquaporin-4 — The primary water channel in the brain; its polarization on astrocyte end-feet is crucial for fluid homeostasis.

Deep Dive — Evidence Details

References

  1. [1]

    Whitehouse DP, Vile AR, Adatia K et al.. “Blood Biomarkers and Structural Imaging Correlations Post-Traumatic Brain Injury: A Systematic Review.” Neurosurgery (2022). PMID: 34995235 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  2. [2]

    Bang OY, Chung JW, Kim SK et al.. “Therapeutic-induced hypertension in patients with noncardioembolic acute stroke.” Neurology (2019). PMID: 31645472 ↗

    L1bRCTCited in: Definition, Synonyms, and Classification
  3. [3]

    Azoulay M, Chang SD, Gibbs IC et al.. “A phase I/II trial of 5-fraction stereotactic radiosurgery with 5-mm margins with concurrent temozolomide in newly diagnosed glioblastoma: primary outcomes.” Neuro-oncology (2020). PMID: 32002547 ↗

    L2bTRIAL_NONRANDOMCited in: Definition, Synonyms, and Classification
  4. [4]

    Li S, Sun H, Liu X et al.. “Mannitol Improves Intraoperative Brain Relaxation in Patients With a Midline Shift Undergoing Supratentorial Tumor Surgery: A Randomized Controlled Trial.” Journal of neurosurgical anesthesiology (2020). PMID: 30789384 ↗

    L1bRCTCited in: Definition, Synonyms, and Classification
  5. [5]

    Qin J, Li C, Fu J et al.. “Construction and application of a nomogram model for predicting postoperative cerebral edema in meningiomas based on radiomics and clinical features.” Acta radiologica (Stockholm, Sweden : 1987) (2025). PMID: 40474660 ↗

    L1bRCTCited in: Definition, Synonyms, and Classification, Epidemiology and Risk Factors
  6. [6]

    Pansell J, Hack R, Rudberg P et al.. “Can Quantitative Pupillometry be used to Screen for Elevated Intracranial Pressure? A Retrospective Cohort Study.” Neurocritical care (2022). PMID: 35606562 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  7. [7]

    Hasan TF, Duarte W, Akinduro OO et al.. “Nonaneurysmal "Pseudo-Subarachnoid Hemorrhage" Computed Tomography Patterns: Challenges in an Acute Decision-Making Heuristics.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2018). PMID: 29884521 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification, Differential Diagnosis
  8. [8]

    Molano Franco D, Nieto Estrada VH, Gonzalez Garay AG et al.. “Interventions for preventing high altitude illness: Part 3. Miscellaneous and non-pharmacological interventions.” The Cochrane database of systematic reviews (2019). PMID: 31012483 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  9. [9]

    Liao WJ, Hsiao CY, Chen CH et al.. “Spontaneous Resolution of an Aggressive Direct Carotid Cavernous Fistula Following Partial Transvenous Embolization Treatment: A Case Report and Review of Literatures.” Medicina (Kaunas, Lithuania) (2024). PMID: 39768891 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification
  10. [10]

    Nobleza COS. “Intracerebral Hemorrhage.” Continuum (Minneapolis, Minn.) (2021). PMID: 34618759 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  11. [11]

    Gewirtz AN, Gao V, Parauda SC et al.. “Posterior Reversible Encephalopathy Syndrome.” Current pain and headache reports (2021). PMID: 33630183 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  12. [12]

    Pang L, Xu X, Liu Y et al.. “A case report and literature review of neuropsychiatric lupus presenting with coma as the initial symptom.” Medicine (2026). PMID: 41560092 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification, Etiology and Triggering Factors, History and Physical Examination
  13. [13]

    Patel PP, Egodage T. “Failing kidneys: renal replacement therapies in the ICU.” Trauma surgery & acute care open (2024). PMID: 38646026 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  14. [14]

    Schilling J, Compton F, Schmidt-Ott K. “[Hypo- and hypernatremia in the intensive care unit : Pitfalls in volume management].” Medizinische Klinik, Intensivmedizin und Notfallmedizin (2021). PMID: 34599374 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  15. [15]

    Eibach S, Moes G, Kim J et al.. “Intracranial infantile hemangioma - rare entity and common pitfalls: A comprehensive multidisciplinary approach from Neurosurgery, Neurooncology and Neuropathology.” Clinical neuropathology (2021). PMID: 33560215 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification
  16. [16]

    Khan AB, McDonald MF, English C et al.. “Integrated Clinical Genetic Analysis Reveals Transcriptional Neurotransmitter Receptor Dysregulation in Meningiomas Causing Seizure.” Neurosurgery (2026). PMID: 41677355 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  17. [17]

    Xu X, Xu X, Ma J et al.. “Clinical Benefit of Thrombectomy in Large-Core Infarction Patients Is Mediated by Malignant Cerebral Edema Reduction.” Journal of the American Heart Association (2026). PMID: 41568548 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification, Etiology and Triggering Factors, Diagnosis and Workup, Prognosis and Long-term Outcomes
  18. [18]

    Liang J, Zhong S, Lian Y et al.. “Episodic encephalopathy in NOTCH2NLC-related neuronal intranuclear inclusion disease: Clinical spectrum and a proposed classification framework.” Journal of the neurological sciences (2026). PMID: 41455460 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification, Epidemiology and Risk Factors, Diagnosis and Workup
  19. [19]

    Tian B, Chen M, Cheng J et al.. “Factors and outcomes associated with acute kidney injury in brain tumor resection patients: insights from a large US database (2010-2019).” Renal failure (2025). PMID: 41285121 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification, Supportive Care and Complication Management
  20. [20]

    Wang Z, Kulpanowski AM, Copen WA et al.. “Automated detection of severe cerebral edema using explainable deep transfer learning after hypoxic ischemic brain injury.” Resuscitation (2025). PMID: 40414341 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification, History and Physical Examination
  21. [21]

    Upadhyay R, Elguindy ANM, Salts L et al.. “Boswellia Serrata for Cerebral Radiation Necrosis After Radiosurgery for Brain Metastases.” International journal of radiation oncology, biology, physics (2025). PMID: 39993542 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  22. [22]

    Ramesh R, Yue JK, Manley GT et al.. “Epidemiology of Intimate Partner and Domestic Violence-Related Traumatic Brain Injury in the United States, 2018 to 2021: A National Trauma Data Bank Cohort Analysis of 3891 Patients.” Neurosurgery (2024). PMID: 38747596 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  23. [23]

    Teske N, Teske NC, Greve T et al.. “Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3.” Acta neurochirurgica (2024). PMID: 38581569 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  24. [24]

    Sawaya R, Yamaguchi S, Ishi Y et al.. “Increased CD44 expression in primary meningioma: its clinical significance and association with peritumoral brain edema.” Journal of neurosurgery (2024). PMID: 38335517 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  25. [25]

    Lee SW, Werner B, Anireddy S et al.. “Characteristics, Outcomes, and Its Associated Factors Among Patients Hospitalized With Mild Traumatic Brain Injuries.” American journal of physical medicine & rehabilitation (2024). PMID: 37549368 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  26. [26]

    Hüfner K, Falla M, Brugger H et al.. “Isolated high altitude psychosis, delirium at high altitude, and high altitude cerebral edema: are these diagnoses valid?” Frontiers in psychiatry (2023). PMID: 37599873 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  27. [27]

    Xu W, Yan D, Ning Z. “Associations between multiple sclerosis and in-hospital outcomes of patients with hemorrhagic stroke.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2023). PMID: 37523878 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  28. [28]

    Lo RS, Cromie GA, Tang M et al.. “The functional impact of 1,570 individual amino acid substitutions in human OTC.” American journal of human genetics (2023). PMID: 37146589 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  29. [29]

    Ghneim M, Brasel K, Vesselinov R et al.. “Traumatic Brain Injury in Older Adults: Characteristics, Outcomes, and Considerations. Results From the American Association for the Surgery of Trauma Geriatric Traumatic Brain Injury (GERI-TBI) Multicenter Trial.” Journal of the American Medical Directors Association (2022). PMID: 35283084 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  30. [30]

    Kulpanowski AM, Copen WA, Hancock BL et al.. “Severe cerebral edema in substance-related cardiac arrest patients.” Resuscitation (2022). PMID: 35149137 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  31. [31]

    Hegazi A, Mohamed RG, Kashbour M et al.. “Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Medical principles and practice : international journal of the Kuwait University, Health Science Centre (2026). PMID: 40720947 ↗

    L1aSR_MA_RCTCited in: Epidemiology and Risk Factors, Diagnosis and Workup
  32. [32]

    Falcão L, Gomes PAL, Silva RAS et al.. “Assessing Glibenclamide's efficacy on functional recovery in aneurysmal subarachnoid hemorrhage: A meta-analysis of randomized controlled trials.” Clinical neurology and neurosurgery (2025). PMID: 40107191 ↗

    L1aSR_MA_RCTCited in: Epidemiology and Risk Factors
  33. [33]

    Mohammed HE, Haseeb ME, Bady Z et al.. “The Efficacy and Safety of Glibenclamide in Improving Cerebral Edema and Neurological Outcomes in Stroke: a GRADE-Evaluated Systematic Review and Meta-analysis with Subgroup Analysis.” Neurocritical care (2025). PMID: 40629214 ↗

    L2aSR_OBSCited in: Epidemiology and Risk Factors
  34. [34]

    Chen Y, Mofatteh M, Dai Y et al.. “Decompressive craniectomy after endovascular thrombectomy in acute ischemic stroke: a systematic review.” Acta neurochirurgica (2025). PMID: 40622611 ↗

    L2aSR_OBSCited in: Epidemiology and Risk Factors, Management
  35. [35]

    Song W, Liu Y, Kang C et al.. “Efficacy and safety of Shuxuening injection in intracerebral hemorrhage: a systematic review and meta-analysis.” Frontiers in pharmacology (2025). PMID: 40458793 ↗

    L2aSR_OBSCited in: Epidemiology and Risk Factors
  36. [36]

    Shafieioun A, Ghaffari H, Baradaran M et al.. “Predictive power of artificial intelligence for malignant cerebral edema in stroke patients: a CT-based systematic review and meta-analysis of prevalence and diagnostic performance.” Neurosurgical review (2025). PMID: 40128510 ↗

    L2aSR_OBSCited in: Epidemiology and Risk Factors
  37. [37]

    Sweety S, Panda S, Das RR. “Balanced electrolyte solution vs isotonic saline in the resuscitation of children with diabetic ketoacidosis: A randomized controlled trial.” World journal of clinical pediatrics (2026). PMID: 41884024 ↗

    L1bRCTCited in: Epidemiology and Risk Factors
  38. [38]

    Hou H, Feng B, Zang D et al.. “Safety and Feasibility of YC-6 in Patients With Large Hemispheric Infarction: A Randomized Clinical Trial.” Journal of the American Heart Association (2025). PMID: 41147407 ↗

    L1bRCTCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Prognosis and Long-term Outcomes
  39. [39]

    Dupont J, Dinkova M, Tabillon C et al.. “Infection following a stereotactic brain biopsy: Myth or reality? Retrospective study between 2009 and 2023.” Anaesthesia, critical care & pain medicine (2026). PMID: 41022203 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Management
  40. [40]

    Fustiñana AL, Echeveste JR, Pedalino J et al.. “Implementation of a Clinical Practice Guideline for diabetic ketoacidosis at a tertiary pediatric hospital: a before-after study.” Andes pediatrica : revista Chilena de pediatria (2025). PMID: 41842793 ↗

    L1cGUIDELINECited in: Epidemiology and Risk Factors, Prognosis and Long-term Outcomes, Special Populations
  41. [41]

    Bicknell BT, Malepati A, Taylor MA et al.. “Diagnostic and Prognostic Value of Retinal and Intracranial Hemorrhages in Abusive Head Trauma: A Retrospective Study.” Journal of pediatric ophthalmology and strabismus (2026). PMID: 41817138 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Prognosis and Long-term Outcomes
  42. [42]

    Feininger ES, May CC, Hinduja A et al.. “Risk factor analysis of hypertonic saline non-responders for the treatment of cerebral edema: a retrospective cohort study.” International journal of clinical pharmacy (2026). PMID: 41379290 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Management, Prognosis and Long-term Outcomes
  43. [43]

    Raja J, Mishra R, Kamath S et al.. “Incidence, predictors, and impact of cerebral edema during the early brain injury phase of aneurysmal subarachnoid hemorrhage: A retrospective cohort study.” Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2026). PMID: 41352133 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors
  44. [44]

    Liu Z, Lin Y, Duan X et al.. “Predictors of Malignant Cerebral Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke: A Retrospective Study and Nomogram Development.” World neurosurgery (2026). PMID: 41274648 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Etiology and Triggering Factors, Diagnosis and Workup, Prognosis and Long-term Outcomes
  45. [45]

    Li J, Zhang W, Tang SN et al.. “Endovascular Interventional Thrombolysis Combined With Mild Hypothermia Induced by Intravascular Hypothermia Saline Fails to Improve Outcomes in the Acute Large Vessel Occlusive Cerebral Infarction Patients: A Single-Center Prospective Case-Control Study.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2025). PMID: 40999632 ↗

    L3bCASE_CONTROLCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Management
  46. [46]

    Lu L, Ou H, Wang X et al.. “The impact of sulfonylureas on survival in patients with severe ischemic stroke and type 2 diabetes: A retrospective study based on the MIMIC-IV database.” Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2025). PMID: 40618539 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Management, Supportive Care and Complication Management
  47. [47]

    Lu R, Yan J, Wang S et al.. “Two cases of acute pancreatitis occurring during therapeutic hypothermia for severe brain injury: case report and literature review.” Frontiers in medicine (2026). PMID: 41919147 ↗

    L4CASE_REPORTCited in: Epidemiology and Risk Factors
  48. [48]

    Memarian S, Zolfaghari A, Gharib B et al.. “The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study.” BMC research notes (2025). PMID: 40205526 ↗

    L2bCOHORTCited in: Epidemiology and Risk Factors, Special Populations
  49. [49]

    Ali NM, Alhag MH, Mustafa AE et al.. “Prevalence, Clinical Profile, and Outcomes of Diabetic Ketoacidosis (DKA) in Pediatric ICU Patients in the Middle East: A Systematic Review and Meta-Analysis.” Cureus (2026). PMID: 41859577 ↗

    L2aSR_OBSCited in: Epidemiology and Risk Factors, Supportive Care and Complication Management, Prognosis and Long-term Outcomes
  50. [50]

    Zhang X, Li C, Wang Y et al.. “No-reflow phenomenon after vessel recanalization in acute ischemic stroke: mechanisms, diagnosis, and treatment directions.” Journal of neurology (2026). PMID: 41915244 ↗

    L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors, Etiology and Triggering Factors
  51. [51]

    Trivedi A, Miyazawa BY, Zhang H et al.. “A Dried Platelet-Derived Biologic for Blood-Brain Barrier Repair and Hemorrhage Control Following TBI in Mice.” Blood (2026). PMID: 41843452 ↗

    L5OTHERCited in: Epidemiology and Risk Factors
  52. [52]

    Luo B, Cui W, Zhang M et al.. “Insular infarction synergistically amplifies malignant cerebral edema risk in anterior circulation large vessel occlusion.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2026). PMID: 41763340 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Prognosis and Long-term Outcomes
  53. [53]

    Al-Salahat A, Cheung R, Dilsaver DB et al.. “Factors associated with mortality in posterior reversible encephalopathy syndrome: a nationwide analysis.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2026). PMID: 41731090 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Management, Supportive Care and Complication Management, Prognosis and Long-term Outcomes
  54. [54]

    Schmitt LG, Dohopolski M, de Vis J et al.. “Adaptive MRI-Guided Reirradiation for High-Risk Recurrent Grade 4 Gliomas: Early Clinical Outcomes and Volumetric Response.” International journal of radiation oncology, biology, physics (2026). PMID: 41663034 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Prognosis and Long-term Outcomes
  55. [55]

    Loggini A, Del Brutto VJ, Velez FGS et al.. “Early gastrostomy is associated with more efficient healthcare resource utilization in nontraumatic intracerebral hemorrhage patients.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2026). PMID: 41448379 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Diagnosis and Workup, Management, Prognosis and Long-term Outcomes
  56. [56]

    Sterns RH, Rondon-Berrios H. “Revisiting New Data on the Mortality Benefit of Rapid Correction of Hyponatremia: Déjà Vu All Over Again.” American journal of kidney diseases : the official journal of the National Kidney Foundation (2026). PMID: 41093163 ↗

    L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
  57. [57]

    Burst V, Rabii R, Peto-Madew J et al.. “Severe Hyponatremia in the Emergency Department Incidence of Cerebral Edema and Risk of Osmotic Demyelination Syndrome.” Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2026). PMID: 41069084 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Management
  58. [58]

    Takeuchi I, Muraoka S, Kinoshita F et al.. “Efficacy of combined clazosentan and cilostazol therapy for cerebral vasospasm after subarachnoid hemorrhage: a retrospective multicenter registry study.” Journal of neurosurgery (2026). PMID: 40972040 ↗

    L5OTHERCited in: Epidemiology and Risk Factors, Management
  59. [59]

    Dabbagh Ohadi MA, Soleimani S, Kakoienejad MM et al.. “Clinical benefits of photodynamic therapy in glioblastoma: systematic review and meta-analysis.” Journal of neurosurgery (2026). PMID: 41569684 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors, Diagnosis and Workup, Management, Prognosis and Long-term Outcomes
  60. [60]

    Li M, Pan Y, Jiang G et al.. “Bevacizumab plus chemotherapy versus chemotherapy in untreated advanced non-squamous non-small-cell lung cancer patients with brain metastases (BAP BRAIN): an open-label, randomized, multicenter, phase III study.” ESMO open (2025). PMID: 41270700 ↗

    L1bRCTCited in: Etiology and Triggering Factors, Management
  61. [61]

    Macháček M, Bébarová M. “Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines.” Neurotoxicology (2026). PMID: 41544778 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors, History and Physical Examination
  62. [62]

    Gigliotti MJ, Jareczek FJ. “Indications and Timing in Ischemic Infarction and Other Disorders.” Neurosurgery clinics of North America (2026). PMID: 41967892 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors, Prognosis and Long-term Outcomes, Landmark Trials and Key Evidence
  63. [63]

    de Sousa ÍA, Machado ADS, Veras AO et al.. “Reversible cerebral vasoconstriction syndrome: A narrative review.” Headache (2026). PMID: 41902495 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors
  64. [64]

    Nguyen M, Oh S, King M et al.. “Current Management of Resistant Hypertension in Patients with Intracerebral Hemorrhage.” International journal of molecular sciences (2026). PMID: 41898576 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors
  65. [65]

    Qin W, Zhao Y, Du J et al.. “Insights into the potential pathogenesis and therapeutic implications of ferroptosis in brain microvascular endothelial cells during stroke.” Frontiers in immunology (2026). PMID: 41836429 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors, Pathophysiology
  66. [66]

    Yan X, Shen H, Zhao M et al.. “Time Is of the Essence: Temporal Dynamics of Epigenetic Landscapes as Therapeutic Targets in Traumatic Brain Injury.” ACS chemical neuroscience (2026). PMID: 41565603 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors
  67. [67]

    Najjar M, Fleming M. “Pediatric stroke: From emergent evaluation to rehabilitation.” Current problems in pediatric and adolescent health care (2025). PMID: 41353016 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors, Differential Diagnosis, Supportive Care and Complication Management
  68. [68]

    Chen Y, Yin X, Zhang E et al.. “Astrocyte-Derived Exosomal miR-211-5p Alleviates Blood-Brain Barrier Injury in a Rat Model of Traumatic Brain Injury.” CNS neuroscience & therapeutics (2026). PMID: 41954515 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology
  69. [69]

    Tan Y, Ye H, Ge Q et al.. “Multimodal MR Imaging Reveals the Mechanisms of Post-Cardiac-Arrest Brain edema: Ferroptosis-Mediated BBB Disruption and AQP4 Dysfunction.” Journal of magnetic resonance imaging : JMRI (2026). PMID: 41933462 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  70. [70]

    Shen W, Jiang C, Liu X et al.. “Astragaloside IV alleviates post-traumatic cytotoxic edema via inhibition of AQP4 expression and subcellular localization.” Phytomedicine : international journal of phytotherapy and phytopharmacology (2026). PMID: 41916121 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  71. [71]

    Nakagawa M, Tomura S, Toyooka T et al.. “Preconditioning Effect of Hydrogen Gas on Traumatic Brain Injury.” Journal of neurotrauma (2026). PMID: 41877520 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  72. [72]

    Li X, Gao Y, Ye Y et al.. “Cyanidin-3-glucoside confers neuroprotection in ischemic stroke by targeting NOX4-mediated oxidative stress: A network pharmacology and experimental validation study.” Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (2026). PMID: 41616469 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  73. [73]

    Poulain A, Riseth J, Emblem KE et al.. “Modeling glioma-induced impairments on the glymphatic system.” Fluids and barriers of the CNS (2026). PMID: 41612346 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology
  74. [74]

    Zhou YF, Yang SB, Zhang F et al.. “Microvascular endothelial metabolic dysfunction drives cerebral edema through bioenergetic failure after ischemia-reperfusion.” Theranostics (2026). PMID: 41608584 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  75. [75]

    Malhotra AK, Nathens AB, Shakil H et al.. “Predicting Return Home After Moderate-to-Severe Traumatic Brain Injury.” Neurology (2026). PMID: 41604614 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  76. [76]

    Yu MJ, Xiong RQ, Wu JW et al.. “β-Hydroxybutyrate improves glymphatic system function and alleviates cerebral edema in mice after ischemic stroke.” Acta pharmacologica Sinica (2026). PMID: 41535708 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology, Management
  77. [77]

    Petersen NH, Begunova L, Olexa M et al.. “Autoregulation-Guided Blood Pressure Targets After Stroke Thrombectomy: Impact on Secondary Brain Injury and Neurologic Outcomes.” Neurology (2026). PMID: 41512207 ↗

    L5OTHERCited in: Etiology and Triggering Factors, History and Physical Examination, Diagnosis and Workup, Prognosis and Long-term Outcomes
  78. [78]

    Shang H, Xu R, Niu H et al.. “20(S)-Protopanaxadiol regulating glucocorticoid receptor attenuates ischemic stroke injury by alleviating the autophagy-lysosomal pathway dysfunction and neuroinflammation.” Phytomedicine : international journal of phytotherapy and phytopharmacology (2026). PMID: 41499936 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  79. [79]

    Cohen C, Debacker C, Le Berre A et al.. “Revisiting the Optimal Apparent Diffusion Coefficient Threshold for Ischemic Core Delineation.” Neurology (2026). PMID: 41453127 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Diagnosis and Workup
  80. [80]

    Jin L, Yang Z, Wei B et al.. “Amelioration of Post-Stroke Edema and Microcirculatory Dysfunction via Targeted AQP4 Inhibition While Preserving the Glymphatic System.” Advanced science (Weinheim, Baden-Wurttemberg, Germany) (2026). PMID: 41387988 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology
  81. [81]

    Banderwal R, Kumar A. “Neuroprotective mechanism of syringic acid targeting oxidative damage and neuroinflammation in an experimental model of traumatic brain injury.” Inflammopharmacology (2026). PMID: 41369867 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  82. [82]

    Zhang X, Liu B, Shao D et al.. “Anti-inflammatory and neuroprotective effect of bryodulcosigenin against cerebral ischemia/reperfusion injury via modulation of inflammatory signaling pathways.” Inflammopharmacology (2026). PMID: 41269478 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology
  83. [83]

    Viveros-Bartolomé JM, Pérez-Mora S, Alquisiras-Burgos I et al.. “Extract of Bacopa procumbens Mitigates Brain Injury and Improves Functional Outcomes Following Ischemia-Reperfusion.” International journal of molecular sciences (2025). PMID: 41465215 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  84. [84]

    Li M, Huo X, Zhao X et al.. “Nr1d1 Regulates Microglia M1/M2 Polarization to Alleviate Neuroinflammation after Traumatic Brain Injury.” ACS chemical neuroscience (2025). PMID: 41296614 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  85. [85]

    Escudero C, Vatish M. “Review: The potential role of placental extracellular vesicles in blood-brain barrier disruption and neuroinflammation in preeclampsia.” Placenta (2026). PMID: 40229181 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology, Special Populations
  86. [86]

    Shi Y, Liang T, Shi C et al.. “Molecular mechanisms of streptococcal disruption of the blood-brain barrier and their pathogenic role in bacterial meningitis.” Frontiers in immunology (2025). PMID: 41573555 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  87. [87]

    García Ríos CA, Leon-Rojas JE. “Aquaporin-4 in Stroke and Brain Edema-Friend or Foe?” International journal of molecular sciences (2025). PMID: 40943104 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  88. [88]

    Yang Z, Li P, Wei J. “Perceiving traumatic brain injury from glymphatic system.” Molecular psychiatry (2025). PMID: 40745390 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  89. [89]

    Datta D, John CC. “Pathogenesis of brain injury in cerebral malaria: emerging mechanisms and implications for intervention.” Current opinion in infectious diseases (2025). PMID: 40742185 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  90. [90]

    Weiss A, Ding Y. “Beyond Reperfusion: Adjunctive Therapies Targeting Inflammation, Edema, and Blood-Brain Barrier Dysfunction in Ischemic Stroke.” Cerebrovascular diseases (Basel, Switzerland) (2026). PMID: 40609526 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  91. [91]

    Huang R, Gao L, Dai Y et al.. “Olink Proteomics Reveals CCL2 Aggravates Perihematomal Edema After Intracerebral Hemorrhage in High-Altitude Migrants Via CCR2/NF-κB-Mediated Blood-Brain Barrier Disruption.” CNS neuroscience & therapeutics (2026). PMID: 41944579 ↗

    L5OTHERCited in: Pathophysiology
  92. [92]

    Bai J, Xie N, Hou Y et al.. “SnRNA-seq reveals the ameliorative effects of optimized Xueyu Jingshen formula on high altitude cerebral edema by modulating energy metabolism, inflammation and BBB integrity.” Phytomedicine : international journal of phytotherapy and phytopharmacology (2026). PMID: 41720010 ↗

    L5OTHERCited in: Pathophysiology, Special Populations
  93. [93]

    Palazzo C, Pati R, Gatta RP et al.. “Acute Dehydration Drives Organ-Specific Modulation of Phosphorylated AQP4ex in Brain and Kidney.” International journal of molecular sciences (2026). PMID: 41596269 ↗

    L5OTHERCited in: Pathophysiology
  94. [94]

    Li Y, Yang W, Tang Y et al.. “Aquaporin-4-overexpressing mesenchymal stem cells promote neurological recovery after intracerebral hemorrhage by inhibiting TLR4/NF-κB signaling.” Free radical biology & medicine (2026). PMID: 41380917 ↗

    L5OTHERCited in: Pathophysiology, Management
  95. [95]

    Bevers MB, An J, Yoo A et al.. “Brain Endothelial Soluble ST2 Production and Cerebral Edema in a Rat Model of Ischemic Stroke.” Annals of neurology (2026). PMID: 40833219 ↗

    L5OTHERCited in: Pathophysiology
  96. [96]

    Xue Y, Wan B, Wang Z et al.. “Hydroxychloroquine Prevents High-altitude Cerebral Edema by Inhibiting Endothelial Claudin-5 Autophagic Degradation.” Current neuropharmacology (2026). PMID: 40353467 ↗

    L5OTHERCited in: Pathophysiology, Special Populations
  97. [97]

    Guo P, Siddique R, Qian J et al.. “Apelin-13 Attenuates Blood-Brain Barrier Dysfunction Following Intracerebral Hemorrhage via Targeting the Keap1/Nrf2 Signaling.” CNS neuroscience & therapeutics (2025). PMID: 41459616 ↗

    L5OTHERCited in: Pathophysiology
  98. [98]

    Wu Y, Lv W, Xiong S et al.. “Dalbergia odorifera T.C. Chen leaf extract promotes microglial energy expenditure to phagocytize neutrophils after cerebral ischemia-reperfusion.” Phytomedicine : international journal of phytotherapy and phytopharmacology (2025). PMID: 41253024 ↗

    L5OTHERCited in: Pathophysiology
  99. [99]

    Hou X, Mo X, Zhang X et al.. “Cuproptosis-driven astrocyte reactivity exacerbates experimental cerebral malaria pathogenesis.” Parasites & vectors (2025). PMID: 41214704 ↗

    L5OTHERCited in: Pathophysiology
  100. [100]

    Wu JW, Zhou YT, Wang BX et al.. “Apigenin regulates CCR5/JAK1/STAT1/MMPs signaling to alleviate secondary brain injury after intracerebral hemorrhage and its enhanced delivery via targeted nanoparticles.” Journal of nanobiotechnology (2025). PMID: 41177867 ↗

    L5OTHERCited in: Pathophysiology
  101. [101]

    Michinaga S, Takahashi K, Ogawa Y et al.. “Smoothened Agonist Treatment Mitigates Vasogenic Edema, Neuroinflammation, and Neurological Dysfunction Following Traumatic Brain Injury in Mice.” FASEB journal : official publication of the Federation of American Societies for Experimental Biology (2025). PMID: 41134710 ↗

    L5OTHERCited in: Pathophysiology
  102. [102]

    Yang Y, Chen L, Hou P et al.. “Effects of Irrigation With Normal Saline on Traumatic Brain Injury Combined With Seawater Immersion in Rats.” The Journal of surgical research (2025). PMID: 41073193 ↗

    L5OTHERCited in: Pathophysiology
  103. [103]

    Zhang Y, Wang L, Li D et al.. “Bispecific self-assembled peptides as supra-growth factors for preventing endotheliopathy and improving survival of traumatic brain injury in mice.” Journal of nanobiotechnology (2025). PMID: 41068806 ↗

    L5OTHERCited in: Pathophysiology
  104. [104]

    Wang J, Li L, Xu J et al.. “Neutrophil extracellular traps induce endothelial damage and exacerbate vasospasm in traumatic brain injury.” Theranostics (2025). PMID: 40963908 ↗

    L5OTHERCited in: Pathophysiology
  105. [105]

    Zhang L, Shao Y, Fang Z et al.. “Salvianolic Acid B and Ginsenoside Rg1 Combination Attenuates Cerebral Edema Accompanying Glymphatic Modulation.” Neuroscience bulletin (2025). PMID: 40886214 ↗

    L5OTHERCited in: Pathophysiology
  106. [106]

    Robinson BD, Yeager A, Lomas A et al.. “Quercetin Protects Blood-Brain Barrier Integrity and Maintains Microvascular Permeability Following Traumatic Brain Injury.” Neurocritical care (2025). PMID: 40739078 ↗

    L5OTHERCited in: Pathophysiology
  107. [107]

    Xue YF, Wu YX, Zhang YZ et al.. “Gper1 inhibition exacerbates traumatic brain injury-induced neurological impairments in mice.” Behavioral and brain functions : BBF (2025). PMID: 40605012 ↗

    L5OTHERCited in: Pathophysiology
  108. [108]

    Li Y, Zhou H, Xie J et al.. “Targeting TRPV4 to restore glymphatic system function and alleviate cerebral edema in ischemic stroke.” Brain pathology (Zurich, Switzerland) (2025). PMID: 40481713 ↗

    L5OTHERCited in: Pathophysiology
  109. [109]

    Łagowski W, Grodzka O, Domitrz I. “Atypical neurological symptoms at high altitude: a systematic literature review.” Travel medicine and infectious disease (2025). PMID: 40379194 ↗

    L2aSR_OBSCited in: History and Physical Examination, Special Populations
  110. [110]

    Tanti MJ, Nevitt S, Yeo M et al.. “Oedema as a prognostic factor for seizures in meningioma - a systematic review and meta-analysis.” Neurosurgical review (2025). PMID: 39969698 ↗

    L2aSR_OBSCited in: History and Physical Examination
  111. [111]

    Ebell MH, Barry HC, Baduni K et al.. “Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis.” Annals of family medicine (2024). PMID: 38253509 ↗

    L2aSR_OBSCited in: History and Physical Examination
  112. [112]

    Wang H, Nery ESM, Ardayfio P et al.. “The effect of modified donanemab titration on amyloid-related imaging abnormalities with edema/effusions and amyloid reduction: 18-month results from TRAILBLAZER-ALZ 6.” The journal of prevention of Alzheimer's disease (2025). PMID: 40619285 ↗

    L1bRCTCited in: History and Physical Examination
  113. [113]

    Zhang G, Chen C, Ren X et al.. “Effects of Intensive Blood Pressure Lowering on Brain Swelling in Thrombolyzed Acute Ischemic Stroke: The ENCHANTED Results.” Stroke (2025). PMID: 40177745 ↗

    L1bRCTCited in: History and Physical Examination
  114. [114]

    Greer DM, Helbok R, Badjatia N et al.. “Fever Prevention in Patients With Acute Vascular Brain Injury: The INTREPID Randomized Clinical Trial.” JAMA (2024). PMID: 39320879 ↗

    L1bRCTCited in: History and Physical Examination
  115. [115]

    Yun J, Kim KH, Jung JW et al.. “Effects of blood pressure lowering in patients treated with intravenous thrombolysis before endovascular thrombectomy.” International journal of stroke : official journal of the International Stroke Society (2025). PMID: 39819210 ↗

    L2bTRIAL_NONRANDOMCited in: History and Physical Examination
  116. [116]

    Song X, Wang Y, Guo W et al.. “Time-varying association between blood pressure and malignant brain edema after large hemispheric infarction: a prospective cohort study.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2025). PMID: 40155579 ↗

    L2bCOHORTCited in: History and Physical Examination
  117. [117]

    Evans AS, Singh S, Joshi C et al.. “Examining Clinical Features and Severe Neurologic Disease of Parechovirus Infection in Young Infants: A Multistate Cohort Study.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2024). PMID: 39093815 ↗

    L2bCOHORTCited in: History and Physical Examination
  118. [118]

    Özen Olcay H, Emektar E, Çorbacıoğlu ŞK et al.. “A retrospective study of CT scan utilization in the emergency department for patients presenting with seizures.” The American journal of emergency medicine (2024). PMID: 38583342 ↗

    L2bCOHORTCited in: History and Physical Examination
  119. [119]

    You L, Hu M, Li J et al.. “The mechanism of electroacupuncture treatment for post-stroke spasticity: A systematic review and Meta-analysis.” Behavioural brain research (2026). PMID: 41101592 ↗

    L2aSR_OBSCited in: History and Physical Examination, Management
  120. [120]

    Nimmo A, Younsi A. “The Relationship Between Inflammation and the Development of Cerebral Ischaemia and Hypoxia in Traumatic Brain Injury-A Narrative Review.” International journal of molecular sciences (2025). PMID: 40869387 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination
  121. [121]

    Li Z, Zhang J, Zhang X et al.. “Oxygen metabolism abnormalities and high-altitude cerebral edema.” Frontiers in immunology (2025). PMID: 40176814 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination, Special Populations
  122. [122]

    Gao Y, Zhang J, Tang T et al.. “Hypoxia Pathways in Parkinson's Disease: From Pathogenesis to Therapeutic Targets.” International journal of molecular sciences (2024). PMID: 39408813 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination
  123. [123]

    Gatterer H, Villafuerte FC, Ulrich S et al.. “Altitude illnesses.” Nature reviews. Disease primers (2024). PMID: 38902312 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination, Special Populations
  124. [124]

    Han C, Zheng XX, Zhang WF. “High altitude retinopathy: An overview and new insights.” Travel medicine and infectious disease (2024). PMID: 38295966 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination, Special Populations
  125. [125]

    Capece G, Caumo L, Volta S et al.. “Wernicke Encephalopathy Complicating a Distinctive POLG Phenotype With MNGIE-Like Features.” European journal of neurology (2026). PMID: 41841518 ↗

    L4CASE_REPORTCited in: History and Physical Examination
  126. [126]

    Gibson AW, Elser H, Rosso M et al.. “Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab.” Alzheimer's & dementia : the journal of the Alzheimer's Association (2024). PMID: 39215494 ↗

    L4CASE_REPORTCited in: History and Physical Examination
  127. [127]

    Rohm Z, Goldman MD, Riley C et al.. “A 73-Year-Old Woman With Confusion, Visual Field Disturbances, and Edematous White Matter Lesions: From the National Multiple Sclerosis Society Case Conference Proceedings.” Neurology(R) neuroimmunology & neuroinflammation (2024). PMID: 39141887 ↗

    L4CASE_REPORTCited in: History and Physical Examination
  128. [128]

    Diorio C, Hernandez-Miyares L, Espinoza DA et al.. “Quadriparesis and paraparesis following chimeric antigen receptor T-cell therapy in children and adolescents.” Blood (2024). PMID: 38905637 ↗

    L4CASE_REPORTCited in: History and Physical Examination
  129. [129]

    Avorio F, Russelli G, Alduino R et al.. “Early-Onset Seizures After Orthotopic Liver Transplantation: A Single-Center Retrospective Study.” Transplantation proceedings (2025). PMID: 39824671 ↗

    L2bCOHORTCited in: History and Physical Examination, Supportive Care and Complication Management
  130. [130]

    Panda S, Majhi K, Biswas T et al.. “Diagnostic and therapeutic challenges into snakebite-induced thrombotic microangiopathy: a case report and review of the literature.” Journal of medical case reports (2026). PMID: 41519809 ↗

    L4CASE_REPORTCited in: History and Physical Examination, Diagnosis and Workup, Supportive Care and Complication Management
  131. [131]

    Byard RW. “A forensic overview of deaths in mountainous terrain.” Forensic science, medicine, and pathology (2025). PMID: 39503975 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination, Special Populations
  132. [132]

    Cho S, Chu MK. “Headache in Brain Tumors.” Neurologic clinics (2024). PMID: 38575261 ↗

    L5REVIEW_NARRATIVECited in: History and Physical Examination
  133. [133]

    Kang K, Ji Z, Hao Y et al.. “Decreased 24-hour Parasympathetic Activity following Intracerebral Hemorrhage: A Key Factor Correlated with Adverse Perihematomal Edema and Poor Functional Outcomes.” CNS neuroscience & therapeutics (2026). PMID: 41499465 ↗

    L5OTHERCited in: History and Physical Examination, Diagnosis and Workup
  134. [134]

    Lim MS, AlBaram R, Leonard A et al.. “Electrode Tract Oedema in Stereo-Electroencephalography.” Stereotactic and functional neurosurgery (2026). PMID: 40675143 ↗

    L5OTHERCited in: History and Physical Examination
  135. [135]

    Li H, Wang Y, Li L et al.. “Clinical characteristics, imaging, treatment, and prognosis of dural arteriovenous fistula presented with Parkinsonism- a systematic review.” Neurosurgical review (2025). PMID: 40875094 ↗

    L2aSR_OBSCited in: Diagnosis and Workup
  136. [136]

    Polymeris AA, Lioutas VA, Incontri D et al.. “Evolution of Perihematomal Edema Mean Hounsfield Unit and Its Association with Clinical Outcome in Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial.” Neurocritical care (2025). PMID: 40789806 ↗

    L1bRCTCited in: Diagnosis and Workup
  137. [137]

    Krishnan K, Grace E, Woodhouse L et al.. “Baseline characteristics of patients recruited to the mannitol for cerebral oedema after acute intracerebral haemorrhage (MACE-ICH) trial.” Clinical neurology and neurosurgery (2026). PMID: 41690237 ↗

    L1bRCTCited in: Diagnosis and Workup, Management, Prognosis and Long-term Outcomes
  138. [138]

    Krishnan K, Grace E, Woodhouse L et al.. “Mannitol for cerebral oedema after acute intracerebral haemorrhage (MACE-ICH): protocol for a prospective, randomised, open-label, blinded-endpoint phase IIb trial.” BMJ open (2025). PMID: 40721251 ↗

    L2bTRIAL_NONRANDOMCited in: Diagnosis and Workup, Management
  139. [139]

    Réen L, Radman A, Visse E et al.. “Outcome in adult patients with severe TBI, using a management protocol allowing a cerebral perfusion pressure ≤ 60 mmHg - a retrospective study over 10 years.” Acta neurochirurgica (2025). PMID: 41128918 ↗

    L2bCOHORTCited in: Diagnosis and Workup
  140. [140]

    Wang L, Wu G, Cao A et al.. “Effect of APOE ε4 Gene on Perihematomal Edema in Intracerebral Hemorrhage: A Prospective Study.” Neurocritical care (2025). PMID: 40764846 ↗

    L2bCOHORTCited in: Diagnosis and Workup
  141. [141]

    Sulaiman RA, Altassan R, Alshammari R et al.. “Cerebral edema in maple syrup urine disease: spectrum of clinical presentation and treatment outcomes.” Orphanet journal of rare diseases (2025). PMID: 41257986 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup
  142. [142]

    Silva BKO, de Carvalho MCS, Delgado AF et al.. “Neurologic monitoring in children and adolescents with hepatic failure: new mechanisms and non-invasive approach.” Clinics (Sao Paulo, Brazil) (2025). PMID: 41297473 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup, Supportive Care and Complication Management
  143. [143]

    Greene JP, Sigman EJ, Podell J et al.. “The Role of Neuroimaging in Traumatic Brain and Spinal Cord Injury.” Seminars in neurology (2025). PMID: 41119962 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup
  144. [144]

    Walabh P, Karvellas CJ. “What's new in the critical care management of acute liver failure: a focus on global accessibility.” Expert review of gastroenterology & hepatology (2025). PMID: 40883866 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup, Supportive Care and Complication Management
  145. [145]

    Zou M, Li J, Yao H et al.. “Toxic encephalopathy due to mercury: A rare case report and literature review.” Medicine (2025). PMID: 40958342 ↗

    L4CASE_REPORTCited in: Diagnosis and Workup
  146. [146]

    Yu Q, Kothe K, Kwiatek RA et al.. “Evidence of White Matter Neuroinflammation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Diffusion-Based Neuroinflammation Imaging Study.” Human brain mapping (2026). PMID: 41834684 ↗

    L5OTHERCited in: Diagnosis and Workup
  147. [147]

    Wilting FNH, Douwes JPJ, Patel A et al.. “Deep learning-based automated segmentation of intracerebral haemorrhage, intraventricular haemorrhage and perihaematomal oedema on non-contrast CT.” European stroke journal (2026). PMID: 41792040 ↗

    L5OTHERCited in: Diagnosis and Workup
  148. [148]

    Basaran AE, Braune M, Barrantes-Freer A et al.. “FOXC1 expression and radiological predictors of peritumoral brain edema in meningiomas.” Journal of neuro-oncology (2026). PMID: 41632362 ↗

    L5OTHERCited in: Diagnosis and Workup, Prognosis and Long-term Outcomes
  149. [149]

    Cliteur MP, Sondag L, Pegge SAH et al.. “The effect of minimally invasive intracerebral haematoma evacuation on early perihaematomal oedema formation.” European stroke journal (2026). PMID: 41614536 ↗

    L5OTHERCited in: Diagnosis and Workup, Prognosis and Long-term Outcomes
  150. [150]

    El-Abtah ME, Murayi R, Lee J et al.. “Radiological Differentiation Between Intracranial Meningioma and Solitary Fibrous Tumor/Hemangiopericytoma: A Systematic Literature Review.” World neurosurgery (2023). PMID: 36403933 ↗

    L2aSR_OBSCited in: Differential Diagnosis
  151. [151]

    Hanas JS, Hocker JR, Ramajayam G et al.. “Distinguishing neurocysticercosis epilepsy from epilepsy of unknown etiology using a minimal serum mass profiling platform.” Experimental parasitology (2018). PMID: 30096291 ↗

    L1bRCTCited in: Differential Diagnosis
  152. [152]

    Guarnizo A, Albreiki D, Cruz JP et al.. “Papilledema: A Review of the Pathophysiology, Imaging Findings, and Mimics.” Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes (2022). PMID: 35044276 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  153. [153]

    Fishel Bartal M, Sibai BM. “Eclampsia in the 21st century.” American journal of obstetrics and gynecology (2022). PMID: 32980358 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  154. [154]

    Pujari SS, Kulkarni RV, Ojha P et al.. “Acute haemorrhagic leukoencephalitis (AHLE) - our experience and a short review.” Journal of neuroimmunology (2021). PMID: 34739912 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  155. [155]

    Culleton S, Talenti G, Kaliakatsos M et al.. “The spectrum of neuroimaging findings in febrile infection-related epilepsy syndrome (FIRES): A literature review.” Epilepsia (2019). PMID: 30854647 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  156. [156]

    Vilela P. “Acute stroke differential diagnosis: Stroke mimics.” European journal of radiology (2017). PMID: 28551302 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  157. [157]

    Koenigsberg RA, Ross L, Timmerman J et al.. “Case of pediatric cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) syndrome in a 2-year-old girl.” Pediatric radiology (2024). PMID: 38630282 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  158. [158]

    Fujita K, Sonoda K, Miyata T et al.. “Early Identification of Protein S K196E Mutation in a Patient With Cerebral Venous Thrombosis: A Case Report.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2019). PMID: 30352753 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  159. [159]

    Hershman M, Carmody R, Udayasankar UK. “Case 252: Acute Hyperammonemic Encephalopathy Resulting from Late-Onset Ornithine Transcarbamylase Deficiency.” Radiology (2018). PMID: 29558304 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  160. [160]

    V Bonm A, Taylor LP. “Management of Neurologic Complications in Patients with Brain and Spine Tumors.” Seminars in neurology (2024). PMID: 38176424 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  161. [161]

    Panagopoulos D, Themistocleous M, Apostolopoulou K. “Edema of the Floor of the Fourth Ventricle Accompanying Shunt Malfunction and Disappearance of It After Shunt Repair: Case Report and Literature Review.” The American journal of case reports (2019). PMID: 31874952 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  162. [162]

    Gavrilovici C, Miron I, Voroneanu L et al.. “Posterior reversible encephalopathy syndrome in children with kidney disease.” International urology and nephrology (2017). PMID: 28836059 ↗

    L5REVIEW_NARRATIVECited in: Differential Diagnosis
  163. [163]

    Leon G, Halgas B, Sullivan S et al.. “Frontal Lobe Thermal Injury Mimicking Cerebritis on Imaging.” Journal of burn care & research : official publication of the American Burn Association (2026). PMID: 41172149 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  164. [164]

    Demirel E, Dilek O. “Utilizing Radiomics of Peri-Lesional Edema in T2-FLAIR Subtraction Digital Images to Distinguish High-Grade Glial Tumors From Brain Metastasis.” Journal of magnetic resonance imaging : JMRI (2025). PMID: 39254002 ↗

    L5OTHERCited in: Differential Diagnosis
  165. [165]

    Dall'Asta A, Melito C, Petrolini C et al.. “First Intrapartum Sonographic Diagnosis of Fetal Hypoxic-Ischemic Encephalopathy.” Fetal diagnosis and therapy (2025). PMID: 39874954 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  166. [166]

    Lyu TJ, Wang J, Zhao F et al.. “CCL4 as a potential serum factor in differential diagnosis of central nervous system inflammatory diseases and gliomas.” Frontiers in immunology (2024). PMID: 39364412 ↗

    L5OTHERCited in: Differential Diagnosis
  167. [167]

    Czerminski J, Khatri S, Rao B. “Amyloid related imaging abnormalities in the emergency setting.” Emergency radiology (2024). PMID: 39331307 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  168. [168]

    Romano A, Moltoni G, Guarnera A et al.. “Single brain metastasis versus glioblastoma multiforme: a VOI-based multiparametric analysis for differential diagnosis.” La Radiologia medica (2022). PMID: 35316518 ↗

    L5OTHERCited in: Differential Diagnosis
  169. [169]

    Doron O, Zadka Y, Barnea O et al.. “Interactions of brain, blood, and CSF: a novel mathematical model of cerebral edema.” Fluids and barriers of the CNS (2021). PMID: 34530863 ↗

    L5OTHERCited in: Differential Diagnosis
  170. [170]

    Wang H, Faw TD, Lin Y et al.. “Neuroprotective Pentapeptide, CN-105, Improves Outcomes in Translational Models of Intracerebral Hemorrhage.” Neurocritical care (2021). PMID: 33474632 ↗

    L5OTHERCited in: Differential Diagnosis
  171. [171]

    Keynejad RC, David AS. “Psychiatric Morbidity and Its Prognosis in Posterior Reversible Encephalopathy Syndrome.” The Journal of neuropsychiatry and clinical neurosciences (2020). PMID: 32283992 ↗

    L5OTHERCited in: Differential Diagnosis
  172. [172]

    Dong F, Li Q, Jiang B et al.. “Differentiation of supratentorial single brain metastasis and glioblastoma by using peri-enhancing oedema region-derived radiomic features and multiple classifiers.” European radiology (2020). PMID: 32006166 ↗

    L5OTHERCited in: Differential Diagnosis
  173. [173]

    Broocks G, Hanning U, Faizy TD et al.. “Ischemic lesion growth in acute stroke: Water uptake quantification distinguishes between edema and tissue infarct.” Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (2020). PMID: 31072174 ↗

    L5OTHERCited in: Differential Diagnosis
  174. [174]

    Khan M, Dhammu TS, Qiao F et al.. “S-Nitrosoglutathione Mimics the Beneficial Activity of Endothelial Nitric Oxide Synthase-Derived Nitric Oxide in a Mouse Model of Stroke.” Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (2019). PMID: 31680031 ↗

    L5OTHERCited in: Differential Diagnosis
  175. [175]

    Tsai SH, Huang PH, Tsai HY et al.. “Roles of the hypoximir microRNA-424/322 in acute hypoxia and hypoxia-induced pulmonary vascular leakage.” FASEB journal : official publication of the Federation of American Societies for Experimental Biology (2019). PMID: 31461385 ↗

    L5OTHERCited in: Differential Diagnosis
  176. [176]

    Nuño M, Ugiliweneza B, Bardini RL et al.. “Age-related mortality in abusive head trauma.” The journal of trauma and acute care surgery (2019). PMID: 30865156 ↗

    L5OTHERCited in: Differential Diagnosis
  177. [177]

    Spence S, Ng D, Casault C. “Atypical presentation of fulminant primary central nervous system angiitis.” Journal of neuroimmunology (2019). PMID: 30716674 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  178. [178]

    Akcil EF, Dilmen OK, Tunali Y. “Hypertonic saline versus mannitol for brain relaxation in supratentorial tumor surgery: a prospective randomized trial.” Brazilian journal of anesthesiology (Elsevier) (2025). PMID: 40967382 ↗

    L1bRCTCited in: Management
  179. [179]

    Shi Q, Han S, Li X et al.. “Oxygen Therapy for Intracranial Hemorrhage.” CNS neuroscience & therapeutics (2026). PMID: 41735793 ↗

    L2aSR_OBSCited in: Management, Prognosis and Long-term Outcomes
  180. [180]

    Akhavan-Sigari A, Sbaih O, Hori YS et al.. “Perilesional Edema as a Predictor of Local Failure in Metastatic Brain Lesions Treated With Stereotactic Radiosurgery: A Systematic Review and Meta-Analysis.” International journal of radiation oncology, biology, physics (2026). PMID: 40588068 ↗

    L2aSR_OBSCited in: Management
  181. [181]

    Nail J, Herendeen J. “Postoperative Considerations Following Decompressive Hemicraniectomy.” Neurosurgery clinics of North America (2026). PMID: 41967895 ↗

    L5REVIEW_NARRATIVECited in: Management, Supportive Care and Complication Management
  182. [182]

    Tenenbein M. “We need a standardized North American acetylcysteine dosing regimen for the treatment of paracetamol (acetaminophen) poisoning.” Clinical toxicology (Philadelphia, Pa.) (2026). PMID: 41608767 ↗

    L5OTHERCited in: Management, Prognosis and Long-term Outcomes
  183. [183]

    Remore LG, Fiore G, Pirola E et al.. “Perilead Edema in Deep Brain Stimulation: Long-Term Outcomes and Etiologic Correlates.” Neuromodulation : journal of the International Neuromodulation Society (2026). PMID: 41165632 ↗

    L5OTHERCited in: Management
  184. [184]

    Schutzman LM, Taylor SL, Fiehn O et al.. “Metabolomic Assessment of Low- Versus High-Volume Resuscitation in a Combined Porcine Model of Severe Burn and Traumatic Brain Injury.” Shock (Augusta, Ga.) (2026). PMID: 40997256 ↗

    L5OTHERCited in: Management
  185. [185]

    Lieschke F, Zheng Y, Lok J et al.. “Dual antiplatelet therapy increases intracerebral hemorrhage and edema after controlled cortical impact and can be partially encountered by 12/15-lipoxygenase inhibition.” Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (2026). PMID: 40947949 ↗

    L5OTHERCited in: Management
  186. [186]

    West E, Patwardhan UM, Calvo R et al.. “Under pressure: Identifying factors for pediatric patients with severe traumatic brain injury who benefit from external ventricular drainage.” Journal of pediatric surgery (2026). PMID: 40803408 ↗

    L5OTHERCited in: Management
  187. [187]

    Tsuiki N, Aihara T, Hayakawa I et al.. “Child neurology: Early neuroprotective and immunomodulatory intervention in acute shock with encephalopathy and multiorgan failure: Cytokine-storm encephalopathy-case report.” Brain & development (2026). PMID: 41679242 ↗

    L4CASE_REPORTCited in: Management
  188. [188]

    Alavi Darazam I, Isazadeh M, Zaresharifi S et al.. “Infection With Mycobacterium chelonae Following Autologous Facial Fat Grafting: A Case Report and Review of Literature.” Journal of cosmetic dermatology (2026). PMID: 41449970 ↗

    L4CASE_REPORTCited in: Management
  189. [189]

    Prasath S, Harsha SP, Swamy AM et al.. “Revisiting the use of steroids in oncology.” Medical oncology (Northwood, London, England) (2025). PMID: 41452544 ↗

    L5REVIEW_NARRATIVECited in: Management
  190. [190]

    Frost ED, Pruthi A, Tonetti D et al.. “Perihematomal Edema Characteristics After Minimally Invasive Surgery in Intracerebral Hemorrhage.” Critical care explorations (2025). PMID: 41416863 ↗

    L5OTHERCited in: Management
  191. [191]

    Henry DA. “Hyponatremia.” Annals of internal medicine (2025). PMID: 41359965 ↗

    L5REVIEW_NARRATIVECited in: Management
  192. [192]

    Cardoso FS, Lee WM, Karvellas CJ. “Brain CT Scan Diagnostic and Prognostic Value in Patients With Acute Liver Failure and Cerebral Edema: A Multicenter Cohort Study.” Critical care explorations (2025). PMID: 40232229 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  193. [193]

    Xu J, Ren X, Huang X et al.. “Epidemiological and clinical characteristics of ammonia-producing microorganisms in the lungs of patients with severe pneumonia: a multicentre cohort study.” Journal of translational medicine (2024). PMID: 39725980 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  194. [194]

    Alishvandi A, Keikha M, Barancheshemeh M et al.. “Severe Multi-organ dysfunction secondary to Shigella flexneri encephalopathy (Ekiri Syndrome): a case report and review of the literature.” BMC infectious diseases (2025). PMID: 41121076 ↗

    L4CASE_REPORTCited in: Supportive Care and Complication Management
  195. [195]

    Fatahichegeni M, Ansarian MA, Wang Y et al.. “Immune effector cell-associated neurotoxicity syndrome following CAR T-cell therapy: a review of recent advances.” Journal of translational medicine (2025). PMID: 41454396 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
  196. [196]

    Vathi S, Corriero A, Rodríguez EE et al.. “Management and monitoring strategies for severe cerebral malaria: a guide for the intensivist.” Annals of intensive care (2025). PMID: 41060528 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
  197. [197]

    Sieben N, Ramanan M. “Research Priorities for Diabetic Ketoacidosis: An Evidence and Gap Mapping Review.” Medical sciences (Basel, Switzerland) (2025). PMID: 40407548 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management, Special Populations
  198. [198]

    Sen BK, Pan K, Chakravarty A. “Hepatic Encephalopathy: Current Thoughts on Pathophysiology and Management.” Current neurology and neuroscience reports (2025). PMID: 40153081 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management, Landmark Trials and Key Evidence
  199. [199]

    Thorburn SJ, McCarthy J. “More than a fever: Encephalitis due to typhoid fever.” International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2025). PMID: 41022196 ↗

    L4CASE_REPORTCited in: Supportive Care and Complication Management
  200. [200]

    Hata M, Okazaki Y, Tanabe S et al.. “Intravascular hemolysis as an initial complication of acute hyponatremia from water intoxication.” The American journal of emergency medicine (2025). PMID: 40764205 ↗

    L4CASE_REPORTCited in: Supportive Care and Complication Management
  201. [201]

    Mierzewska-Schmidt M, Piwowarczyk A, Szymanska K et al.. “Fatal Fulminant Epstein-Barr Virus (EBV) Encephalitis in Immunocompetent 5.5-Year-Old Girl-A Case Report with the Review of Diagnostic and Management Dilemmas.” Biomedicines (2024). PMID: 39767783 ↗

    L4CASE_REPORTCited in: Supportive Care and Complication Management
  202. [202]

    Totapally B, Barhen A, De Angulo G. “Hemorrhagic complications and outcomes of children with acute promyelocytic leukemia at initial hospital admission: a multicenter cohort study.” Pediatric hematology and oncology (2025). PMID: 40384474 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  203. [203]

    Likhitha S, Rameshkumar R, Delhikumar CG et al.. “Diagnosis (by p-RIFLE and KDIGO) and Risk Factors of Acute Kidney Injury in Pediatric Diabetic Ketoacidosis: A Retrospective Study.” Indian journal of nephrology (2025). PMID: 40352887 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  204. [204]

    Olaya Vargas A, Salazar-Rosales H, Caballero-Palacios M et al.. “High-risk neuroblastoma in Mexico: from multimodal treatment to immunotherapy. Regarding the first case treated with naxitamab.” Frontiers in oncology (2025). PMID: 40606987 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
  205. [205]

    Jiang X, Guo H, Xiao W et al.. “Advancements in Non-Invasive Intracranial Pressure Monitoring via Optic Nerve Sheath Diameter Measurement.” Medical science monitor : international medical journal of experimental and clinical research (2025). PMID: 40413578 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
  206. [206]

    Foti Randazzese S, La Rocca M, Bombaci B et al.. “Severe Diabetic Ketoacidosis in Children with Type 1 Diabetes: Ongoing Challenges in Care.” Children (Basel, Switzerland) (2025). PMID: 39857941 ↗

    L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
  207. [207]

    Būce-Šatoba I, Krūmiņa G, Ozoliņa A. “The Impact of Near-Infrared Spectroscopy in Early Detection of Cerebral Deterioration After Aneurysmal Subarachnoid Haemorrhage.” Journal of clinical medicine (2026). PMID: 41753037 ↗

    L5OTHERCited in: Supportive Care and Complication Management, Prognosis and Long-term Outcomes
  208. [208]

    Wu T, Wang K, Sun B et al.. “An Implantable System Design Based on Neuromorphic Memristor for Post-Craniotomy Intracranial Pressure Monitoring.” ACS applied materials & interfaces (2025). PMID: 41032885 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  209. [209]

    McClelland AC, Ellis CA, Kuo E et al.. “Atypical Edema in Posterior Reversible Encephalopathy Syndrome: Clinical Associations and Outcome.” Journal of neuroimaging : official journal of the American Society of Neuroimaging (2025). PMID: 40824279 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  210. [210]

    Pansell J, Thomsson T, Eng E et al.. “Optic Nerve Sheath Diameter: Which Axis Should Be Measured?” Journal of neuroimaging : official journal of the American Society of Neuroimaging (2025). PMID: 40754891 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  211. [211]

    Kashiwazaki D, Maruyama K, Hamada S et al.. “Infection Associated with Global Cerebral Edema and Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage.” Journal of clinical medicine (2025). PMID: 40507570 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  212. [212]

    Hajimohammadebrahim-Ketabforoush M, Meybodi TE, Mehmandoost M et al.. “Immunonutrition for modifying inflammatory markers and improving clinical outcomes following traumatic brain injury: a systematic review and meta-analysis.” BMC neurology (2025). PMID: 41331904 ↗

    L2aSR_OBSCited in: Prognosis and Long-term Outcomes
  213. [213]

    Feng X, Hua M, Yang C et al.. “Clinical characteristic and prognosis of adult inpatients with high altitude pulmonary edema: a multi-central, retrospective study in plateau of China from 2012 to 2022.” BMC pulmonary medicine (2025). PMID: 41316096 ↗

    L2bCOHORTCited in: Prognosis and Long-term Outcomes
  214. [214]

    Zhang YF, Ma W, Chen L et al.. “Diabetes prolongs hospitalization and increases infection, cerebral edema, and neurological complications in meningioma patients: A retrospective study.” World journal of diabetes (2026). PMID: 41696108 ↗

    L2bCOHORTCited in: Prognosis and Long-term Outcomes
  215. [215]

    Qu HL, Sun XY, Xu XM et al.. “Malignant Cerebral Edema after Large-Core Anterior Circulation Stroke in the Thrombectomy Era: Prediction and Neurocritical Care Pathways.” Neurocritical care (2026). PMID: 41986793 ↗

    L5REVIEW_NARRATIVECited in: Prognosis and Long-term Outcomes, Guidelines and Resources
  216. [216]

    Abdelhakim N, Galecio-Castillo M, Kalakoti P et al.. “Cytotoxic Edema and Intra-parenchymal Hemorrhage: A Mediated Pathway to Mortality and Functional Outcome in Cerebral Venous Sinus Thrombosis- A sub-analysis of the CLOT-VENUS Registry.” Translational stroke research (2026). PMID: 41975110 ↗

    L5OTHERCited in: Prognosis and Long-term Outcomes
  217. [217]

    Chaudhari PP, Durham S, Pineda J et al.. “Development of a neurologic deterioration risk score in pediatric mild traumatic brain injury and intracranial injuries.” The journal of trauma and acute care surgery (2026). PMID: 41925534 ↗

    L5OTHERCited in: Prognosis and Long-term Outcomes
  218. [218]

    Albert S, Jain AK, Malhotra A et al.. “Impact of Laterality on Inpatient Outcomes and Complications of Middle Cerebral Artery Acute Ischemic Stroke.” Stroke (2026). PMID: 41822970 ↗

    L5OTHERCited in: Prognosis and Long-term Outcomes
  219. [219]

    Kasai M, Sakuma H, Suzuki M et al.. “Life-Threatening SARS-CoV-2-Associated Encephalopathy and Multiorgan Failure in Children, Asia and Oceania, 2022-2024.” Emerging infectious diseases (2026). PMID: 41714597 ↗

    L5REVIEW_NARRATIVECited in: Prognosis and Long-term Outcomes
  220. [220]

    Park SY, Oh SH, Kim HJ et al.. “Distinct Coagulation Phenotypes and Long-Term Neurological Outcomes in Post-Cardiac Arrest Syndrome: A Latent Class Analysis of a 9-Year Single-Center Cohort.” Journal of clinical medicine (2026). PMID: 41682968 ↗

    L5OTHERCited in: Prognosis and Long-term Outcomes
  221. [221]

    Han N, Zhang X, Zhang Y et al.. “Predicting early severe midline shift in acute ischemic stroke Within 24 h of endovascular thrombectomy.” Neuroradiology (2026). PMID: 41201490 ↗

    L5OTHERCited in: Prognosis and Long-term Outcomes
  222. [222]

    Kramer AH, Deis N, Ruddell S et al.. “Decompressive Craniectomy in Patients with Traumatic Brain Injury: Are the Usual Indications Congruent with Those Evaluated in Clinical Trials?” Neurocritical care (2016). PMID: 26732269 ↗

    L2bTRIAL_NONRANDOMCited in: Landmark Trials and Key Evidence
  223. [223]

    Rapp A, Kobeissi H, Fahim DK. “Updated Review of the Management of and Guidelines for Traumatic Brain Injury.” Journal of clinical medicine (2025). PMID: 41095876 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  224. [224]

    Szczygielski J, Mautes AE, Müller A et al.. “Decompressive Craniectomy Increases Brain Lesion Volume and Exacerbates Functional Impairment in Closed Head Injury in Mice.” Journal of neurotrauma (2016). PMID: 26102497 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  225. [225]

    Kappus MR, Bajaj JS. “Covert hepatic encephalopathy: not as minimal as you might think.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2012). PMID: 22728384 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  226. [226]

    Allampati SK, Mullen KD. “Understanding the impact of neurologic complications in patients with cirrhosis.” SAGE open medicine (2019). PMID: 30834114 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  227. [227]

    Kolias AG, Adams H, Timofeev I et al.. “Decompressive craniectomy following traumatic brain injury: developing the evidence base.” British journal of neurosurgery (2016). PMID: 26972805 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  228. [228]

    Oeltzschner G, Butz M, Wickrath F et al.. “Covert hepatic encephalopathy: elevated total glutathione and absence of brain water content changes.” Metabolic brain disease (2016). PMID: 26563124 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  229. [229]

    Atluri DK, Prakash R, Mullen KD. “Pathogenesis, diagnosis, and treatment of hepatic encephalopathy.” Journal of clinical and experimental hepatology (2011). PMID: 25755319 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  230. [230]

    Liu J, Wang M, Shi X et al.. “Neural correlates of covert face processing: fMRI evidence from a prosopagnosic patient.” Cerebral cortex (New York, N.Y. : 1991) (2014). PMID: 23448870 ↗

    L4CASE_REPORTCited in: Landmark Trials and Key Evidence
  231. [231]

    Defante MLR, de Souza MM, Mendes BX et al.. “Subcutaneous rapid-acting insulin analogues in mild to moderate diabetic ketoacidosis: A meta-analysis of randomized controlled trials.” Journal of diabetes and its complications (2024). PMID: 39437698 ↗

    L1aSR_MA_RCTCited in: Special Populations
  232. [232]

    Zhou Y, Ding H, Liang H et al.. “Global research trends and emerging hotspots in acute high altitude illness: a bibliometric analysis and review (1937-2024).” Reviews on environmental health (2025). PMID: 40150970 ↗

    L2aSR_OBSCited in: Special Populations
  233. [233]

    Luks AM, Beidleman BA, Freer L et al.. “Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update.” Wilderness & environmental medicine (2024). PMID: 37833187 ↗

    L1cGUIDELINECited in: Special Populations
  234. [234]

    da Mota MF, de Amorim MM, Correia MDT et al.. “The optic nerve sheath in hypertensive disorders of pregnancy and perinatal outcomes: a cohort study.” BMC pregnancy and childbirth (2024). PMID: 39375707 ↗

    L2bCOHORTCited in: Special Populations
  235. [235]

    Small E, Goldberg E, Musi M et al.. “Prochlorperazine maleate versus placebo for the prevention of acute mountain sickness: study protocol for a randomized controlled trial.” Trials (2024). PMID: 39574186 ↗

    L2bTRIAL_NONRANDOMCited in: Special Populations
  236. [236]

    Zila-Velasque JP, Grados-Espinoza P, Goicochea-Romero PA et al.. “Mountain sickness in altitude inhabitants of Latin America: A systematic review and meta-analysis.” PloS one (2024). PMID: 39316567 ↗

    L2aSR_OBSCited in: Special Populations
  237. [237]

    Manoharan MM, Montes GC, Acquarone M et al.. “Metabolic theory of preeclampsia: implications for maternal cardiovascular health.” American journal of physiology. Heart and circulatory physiology (2024). PMID: 38968164 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  238. [238]

    Shinar S, Chitayat D, Shannon P et al.. “Fetal macrocephaly: Pathophysiology, prenatal diagnosis and management.” Prenatal diagnosis (2023). PMID: 38009873 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  239. [239]

    Kumar H, Bhakhri BK, Tyagi V et al.. “Characteristics and clinical relevance of leukocytic response in children with diabetic ketoacidosis - A comparative cohort study.” Archives of endocrinology and metabolism (2024). PMID: 39420911 ↗

    L2bCOHORTCited in: Special Populations
  240. [240]

    Omidi A, Hawley GD, Kain D et al.. “What Is New in Altitude- and Cold-Related Illnesses of Travel: Appraisal and Summary of the Updated Guidelines from the Wilderness Medical Society.” International journal of environmental research and public health (2025). PMID: 40003509 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  241. [241]

    Leung KKY, Tung JYL, Lee YTK et al.. “A Narrative Review on Diabetic Ketoacidosis in Children.” Current pediatric reviews (2025). PMID: 38299411 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  242. [242]

    Derstine M, Jean D, Beidleman BA et al.. “Acute Mountain Sickness and High Altitude Cerebral Edema in Women: A Scoping Review-UIAA Medical Commission Recommendations.” High altitude medicine & biology (2023). PMID: 37870579 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  243. [243]

    Ni SY, Wang N, Luo DY et al.. “Discovery of novel salidroside derivatives as potent hypoxia inducible factor 1α (HIF-1α) signaling inhibitors to treat high altitude cerebral edema.” European journal of medicinal chemistry (2025). PMID: 40706447 ↗

    L5OTHERCited in: Special Populations
  244. [244]

    Fu Q, Qiu R, Tang Q et al.. “Exosomes from high-altitude cerebral edema patients induce cognitive dysfunction by altering oxidative stress responses in mice.” Translational psychiatry (2025). PMID: 40695777 ↗

    L5OTHERCited in: Special Populations
  245. [245]

    Patel M, Afifi AM, Hercher RL et al.. “Reevaluating bicarbonate therapy in pediatric DKA: A propensity score-matched analysis of neurological and respiratory outcomes.” The American journal of emergency medicine (2025). PMID: 40683034 ↗

    L5OTHERCited in: Special Populations
  246. [246]

    Lv W, Ma Y, Li D et al.. “Single-Cell RNA Sequencing and Spatial Transcriptomics Reveal a Novel Mechanism of Oligodendrocyte-Neuron Interaction in Cognitive Decline After High-Altitude Cerebral Edema.” CNS neuroscience & therapeutics (2025). PMID: 40546220 ↗

    L5OTHERCited in: Special Populations
  247. [247]

    DeMayo KM, Havlicek EE, Palumbo J et al.. “Diabetic Ketoacidosis and Venous Thromboembolism: A North American Virtual Pediatric Systems Registry Study, 2014-2023.” Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (2025). PMID: 40439528 ↗

    L5OTHERCited in: Special Populations
  248. [248]

    Han Y, Li W, Duan H et al.. “Ligustrazine hydrochloride Prevents Ferroptosis by Activating the NRF2 Signaling Pathway in a High-Altitude Cerebral Edema Rat Model.” International journal of molecular sciences (2025). PMID: 39940878 ↗

    L5OTHERCited in: Special Populations
  249. [249]

    Bergman L, Hannsberger D, Schell S et al.. “Cerebral infarcts, edema, hypoperfusion, and vasospasm in preeclampsia and eclampsia.” American journal of obstetrics and gynecology (2025). PMID: 39486498 ↗

    L5OTHERCited in: Special Populations
  250. [250]

    Cook AM, Morgan Jones G, Hawryluk GWJ et al.. “Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients.” Neurocritical care (2020). PMID: 32227294 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  251. [251]

    Ghannoum M, Laliberté M, Nolin TD et al.. “Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup.” Clinical toxicology (Philadelphia, Pa.) (2015). PMID: 25950372 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  252. [252]

    Spasovski G, Vanholder R, Allolio B et al.. “Clinical practice guideline on diagnosis and treatment of hyponatraemia.” European journal of endocrinology (2014). PMID: 24569125 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  253. [253]

    Spasovski G, Vanholder R, Allolio B et al.. “Clinical practice guideline on diagnosis and treatment of hyponatraemia.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2014). PMID: 24569496 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  254. [254]

    Wijdicks EF, Sheth KN, Carter BS et al.. “Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association.” Stroke (2014). PMID: 24481970 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  255. [255]

    Stravitz RT, Kramer AH, Davern T et al.. “Intensive care of patients with acute liver failure: recommendations of the U.S. Acute Liver Failure Study Group.” Critical care medicine (2007). PMID: 17901832 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  256. [256]

    Soffietti R, Cornu P, Delattre JY et al.. “EFNS Guidelines on diagnosis and treatment of brain metastases: report of an EFNS Task Force.” European journal of neurology (2006). PMID: 16834697 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  257. [257]

    Vahedi K, Proust F, Geeraerts T. “[Experts' recommendations for stroke management in intensive care: intracranial hypertension].” Revue neurologique (2012). PMID: 22571966 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  258. [258]

    Luks AM, Auerbach PS, Freer L et al.. “Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update.” Wilderness & environmental medicine (2019). PMID: 31248818 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  259. [259]

    Luks AM, McIntosh SE, Grissom CK et al.. “Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update.” Wilderness & environmental medicine (2014). PMID: 25498261 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  260. [260]

    Bennett BL, Hew-Butler T, Hoffman MD et al.. “Wilderness Medical Society practice guidelines for treatment of exercise-associated hyponatremia.” Wilderness & environmental medicine (2013). PMID: 23590928 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  261. [261]

    Luks AM, McIntosh SE, Grissom CK et al.. “Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness.” Wilderness & environmental medicine (2010). PMID: 20591379 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  262. [262]

    Liao KH, Chang CK, Chang HC et al.. “Clinical practice guidelines in severe traumatic brain injury in Taiwan.” Surgical neurology (2009). PMID: 19818476 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  263. [263]

    Park S. “Emergent Management of Spontaneous Subarachnoid Hemorrhage.” Continuum (Minneapolis, Minn.) (2024). PMID: 38830067 ↗

    L4CASE_REPORTCited in: Guidelines and Resources
  264. [264]

    Greige T, Tao BS, Dangayach NS et al.. “Cerebral Edema Monitoring and Management Strategies: Results from an International Practice Survey.” Neurocritical care (2025). PMID: 39085504 ↗

    L5OTHERCited in: Guidelines and Resources
  265. [265]

    Suarez JI. “Diagnosis and Management of Subarachnoid Hemorrhage.” Continuum (Minneapolis, Minn.) (2015). PMID: 26426230 ↗

    L5REVIEW_NARRATIVECited in: Guidelines and Resources
  266. [266]

    Zha AM, Sari M, Torbey MT. “Recommendations for management of large hemispheric infarction.” Current opinion in critical care (2015). PMID: 25689126 ↗

    L5REVIEW_NARRATIVECited in: Guidelines and Resources
  267. [267]

    Hays AN, Lazaridis C, Neyens R et al.. “Osmotherapy: use among neurointensivists.” Neurocritical care (2011). PMID: 21153930 ↗

    L5OTHERCited in: Guidelines and Resources

Revision History

All updates applied to this page

Loading revisions…