Perhaps one of the most obvious gross changes found in the brain following a severe injury to the head is an increase in its fluid content. This is commonly referred to as cerebral edema. At autopsy the brain appears swollen, and under certain circumstances it is probably actually heavier than normal. The increase in fluid, as judged by gross appearance, is general in distribution. It is not confined to the substance of the brain alone, although this tissue may be wetter than normal; in addition, there is often an excess of fluid in the subarachnoid space and in the ventricular system. This excess of cerebrospinal fluid may be demonstrated clinically. At lumbar puncture the pressure of the fluid is usually increased, the rapidity of its flow is quickened, and the actual amount that may be withdrawn is often considerably greater than normal. The presence of a "wet" edematous brain is
RAND CW. HISTOLOGIC STUDIES OF THE BRAIN IN CASES OF FATAL INJURY TO THE HEAD: I. PRELIMINARY REPORT. Arch Surg. 1931;22(5):738–753. doi:10.1001/archsurg.1931.01160050049003
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