Vasogenic edema

Vasogenic edema
Malignant meningioma; A proton density image in the horizontal plane emphasizes the large white area of vasogenic edema. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Vasogenic edema is a specific form of edema in which increased extracellular fluid accumulates in the brain due to breakdown of the blood-brain barrier. It is generally more prominent in white matter than gray matter.

Vasogenic edema results from an increase in vessel permeability due to inflammatory process or neoplasm. The integrity of normal blood-brain barrier is disrupted; increased vascular permeability allows fluid to escape into intracellular spaces of the brain.

Diagnostic Findings

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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  Choroid plexus papilloma (CPP). This 9 month old child presented with a history of lethargy. T1 weighted axial MRI reveals an intermediate signal mass in the lateral ventricle. T1 weighted axial MRI after gadolinium shows intense, homogeneous enhancement of the mass in the lateral ventricle.

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  Choroid plexus papilloma: T2 weighted axial MRI shows intense surrounding vasogenic edema. Choroid plexus papilloma (CPP) are the most common tumor arising in the trigone of the lateral ventricle in children. They represent 2-5% of all primary brain tumors in children, with almost 90% occurring in children less than five years old. In children, they usually arise in the trigone of the lateral ventricle. In adults they commonly arise in the fourth ventricle. Less than 10% occur in the third ventricle or elsewhere. Patients usually present with hydrocephalus.

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  Choroid plexus papilloma: T2 weighted axial MRI shows intense surrounding vasogenic edema. CPPs typically enhance dramatically following contrast administration on CT or MRI. Parenchymal invasion with edema may occur. Imaging findings are not reliable for distinguishing between CPP and choroid plexus carcinoma, which represent about 10% of choroid plexus neoplasms.