{"id":1997,"date":"2023-02-07T11:20:21","date_gmt":"2023-02-07T11:20:21","guid":{"rendered":"https:\/\/www.karotidnahirurgija.com\/?page_id=1997"},"modified":"2023-02-24T10:54:32","modified_gmt":"2023-02-24T10:54:32","slug":"3-2-edem-mozga-u-shemiji-mozga","status":"publish","type":"page","link":"https:\/\/www.karotidnahirurgija.com\/?page_id=1997","title":{"rendered":"3.2. EDEM MOZGA U ISHEMIJI MOZGA"},"content":{"rendered":"

\"\"<\/a><\/p>\n

\n

ETIOPATOGENEZA KAROTIDNE BOLESTI<\/h1>\n<\/h1>\n
\n

\n

3.2. EDEM MOZGA U ISHEMIJI MOZGA

<\/h3>\n<\/div>\n
\n

Edem<\/span> <\/span>mozga<\/span> <\/span>je<\/span> <\/span>porast<\/span> <\/span>zapremine<\/span> <\/span>tkiva<\/span> <\/span>usled<\/span> <\/span>pove\u0107anja<\/span> <\/span>sadr\u017eaja<\/span> <\/span>te\u010dnosti<\/span> <\/span>u<\/span> <\/span>njemu.<\/span> <\/span>Edem<\/span> <\/span>mozga<\/span> <\/span>tokom<\/span> <\/span>cerebralne<\/span> <\/span>ishemije<\/span> <\/span>mo\u017ee<\/span> <\/span>biti<\/span> <\/span>citotoksi\u010dni<\/span> <\/span>i<\/span> <\/span>vazogeni.<\/span><\/p>\n

Citotoksi\u010dni<\/b><\/span> <\/b><\/span>(metaboli\u010dki)<\/b><\/span> <\/b><\/span>edem<\/b><\/span> <\/b><\/span>mozga<\/span> <\/span>nastaje<\/span> <\/span>intracelularnom<\/span> <\/span>akumulacijom<\/span> <\/span>vode,<\/span> <\/span>a<\/span> <\/span>krvno-mo\u017edana<\/span> <\/span>barijera<\/span> <\/span>je<\/span> <\/span>neo\u0161te\u0107ena.<\/span><\/p>\n

Vazogeni<\/b><\/span> <\/b><\/span>edem<\/b><\/span> <\/b><\/span>je<\/span> <\/span>posledica<\/span> <\/span>promena<\/span> <\/span>na<\/span> <\/span>krvnim<\/span> <\/span>sudovima<\/span> <\/span>koje<\/span> <\/span>omogu\u0107avaju<\/span> <\/span>prolaz<\/span> <\/span>proteina<\/span> <\/span>i<\/span> <\/span>sastojaka<\/span> <\/span>krvi<\/span> <\/span>kroz<\/span> <\/span>lediranu<\/span> <\/span>krvno-mo\u017edanu<\/span> <\/span>barijeru.<\/span><\/p>\n

Edem<\/span> <\/span>u<\/span> <\/span>ishemiji<\/span> <\/span>mozga<\/span> <\/span>zapo\u010dinje<\/span> <\/span>kao<\/span> <\/span>citotoksi\u010dan,<\/span> <\/span>a<\/span> <\/span>sa<\/span> <\/span>o\u0161te\u0107enjem<\/span> <\/span>krvno-<\/span> <\/span>mo\u017edane<\/span> <\/span>barijere<\/span> <\/span>razvija<\/span> <\/span>se<\/span> <\/span>i<\/span> <\/span>vazogena<\/span> <\/span>komponenta.<\/span> <\/span>On<\/span> <\/span>zapo\u010dinje<\/span> <\/span>kao<\/span> <\/span>posledica<\/span> <\/span>metaboli\u010dk<\/span>e<\/span> <\/span>insu<\/span>f<\/span>i<\/span>cijencij<\/span>e<\/span> <\/span>odr\u017eanj<\/span>a<\/span> <\/span>Na<\/span>,<\/span> <\/span>K<\/span> <\/span>homeostaz<\/span>e<\/span> <\/span>(pumpe)<\/span>.<\/span> <\/span>V<\/span>od<\/span>a<\/span> <\/span>i<\/span>z<\/span> <\/span>ekstracelularnog<\/span> <\/span>prelazi<\/span> <\/span>u<\/span> <\/span>intracelularni<\/span> <\/span>prostor.<\/span> <\/span>Astrocitni<\/span> <\/span>nastavci<\/span> <\/span>bubre<\/span> <\/span>neposredno<\/span> <\/span>oko<\/span> <\/span>krvnih<\/span> <\/span>sudova.<\/span> <\/span>Time<\/span> <\/span>se<\/span> <\/span>pogor\u0161ava<\/span> <\/span>ishemija<\/span> <\/span>neurona.<\/span><\/p>\n

Tranzitorne <\/span>epizode<\/span> <\/span>ishemije<\/span> <\/span>zbog lokalne<\/span> <\/span>hipoperfuzije pra\u0107ene<\/span> <\/span>su<\/span> lokalnim<\/span> <\/span>edemom.<\/span> <\/span>Ako<\/span> <\/span>se<\/span> <\/span>embolus<\/span> <\/span>fragmentira<\/span> <\/span>i<\/span> <\/span>omogu\u0107i<\/span> <\/span>priliv<\/span> <\/span>krvi<\/span> <\/span>u<\/span> <\/span>distalne<\/span> <\/span>krvne<\/span> <\/span>sudove<\/span> <\/span>koji<\/span> <\/span>su<\/span> <\/span>izgubuli<\/span> <\/span>autoregulaciju<\/span> <\/span>te<\/span> <\/span>su<\/span> <\/span>izlo\u017eeni<\/span> <\/span>sistemskim<\/span> <\/span>pritiscima,<\/span> <\/span>u<\/span> <\/span>okolini<\/span> <\/span>ishemi\u010dke<\/span> <\/span>lezije<\/span> <\/span>postoja\u0107e<\/span> <\/span>kongestija<\/span> <\/span>edem.<\/span><\/p>\n

Za<\/span> <\/span>razvoj<\/span> <\/span>edema<\/span> <\/span>mozga<\/span> <\/span>potrebna<\/span> <\/span>je<\/span> <\/span>o\u010duvana<\/span> <\/span>cirkulacija.<\/span> <\/span>U<\/span> <\/span>stanjima<\/span> <\/span>potpunog<\/span> <\/span>prekid<\/span>a<\/span> <\/span>cirkulacij<\/span>e<\/span> <\/span>ede<\/span>m<\/span> <\/span>s<\/span>e<\/span> <\/span>n<\/span>e<\/span> <\/span>ra<\/span>z<\/span>vija<\/span>,<\/span> <\/span>iak<\/span>o<\/span> <\/span>s<\/span>u<\/span> <\/span>ene<\/span>r<\/span>getsk<\/span>e<\/span> <\/span>rezerv<\/span>e<\/span> <\/span>(<\/span>A<\/span>TP<\/span>)<\/span> <\/span>iscrpljene<\/span>.<\/span> <\/span>Za<\/span> <\/span>rezoluciju<\/span> <\/span>edema,<\/span> <\/span>tako\u0111e,<\/span> <\/span>potrebna<\/span> <\/span>je<\/span> <\/span>o\u010duvanost<\/span> <\/span>izvesnog<\/span> <\/span>stepena<\/span> <\/span>cirkulacije.<\/span> <\/span>Stoga<\/span> <\/span>se<\/span> <\/span>u<\/span> <\/span>razvoju<\/span> <\/span>i<\/span> <\/span>rezoluciji<\/span> <\/span>edema<\/span> <\/span>izazvanog<\/span> <\/span>ishemijom,<\/span> <\/span>razlikuju<\/span> <\/span>dve<\/span> <\/span>faze:<\/span> <\/span>aktivna<\/span> <\/span>i<\/span> <\/span>pasivna.<\/span><\/p>\n

Aktivna<\/span> <\/span>faza<\/span> <\/span>je<\/span> <\/span>period<\/span> <\/span>o\u010duvane<\/span> <\/span>cirkulacije.<\/span> <\/span>U<\/span> <\/span>aktivnoj<\/span> <\/span>fazi<\/span> <\/span>mogu\u0107e<\/span> <\/span>je<\/span> <\/span>dopremanja<\/span> <\/span>antiedematozne<\/span> <\/span>terapije,<\/span> <\/span>i<\/span> <\/span>rezolucija<\/span> <\/span>edema.<\/span> <\/span>U<\/span> <\/span>pasivnoj<\/span> <\/span>fazi<\/span> <\/span>cirkulacija<\/span> <\/span>je<\/span> <\/span>toliko<\/span> <\/span>insuficijentna<\/span> <\/span>da<\/span> <\/span>do<\/span> <\/span>ishemi\u010dnih<\/span> <\/span>regiona<\/span> <\/span>ne<\/span> <\/span>sti\u017eu<\/span> <\/span>ni<\/span> <\/span>lekovi.<\/span> <\/span>Samo<\/span> <\/span>terapija<\/span> <\/span>ordinirana<\/span> <\/span>u<\/span> <\/span>akutnoj<\/span> <\/span>fazi,<\/span> <\/span>\u0161to<\/span> <\/span>pre,<\/span> <\/span>pokazuje<\/span> <\/span>antiedematozni<\/span> <\/span>i<\/span> <\/span>metaboli\u010dki<\/span> <\/span>efekat.<\/span><\/p>\n

Osetljivost pojedinih regiona mozga na ishemiju je razli\u010dita. Normalno je protok ve\u0107i u sivoj masi. Energetski zahtevi su ve\u0107i u sivoj masi no u beloj masi mozga. Zato je siva masa osetljivija na ishemiju, pa se i citotoksi\u010dni edem inicijalno javlja u sivoj masi mozga.<\/p>\n<\/div>\n


\n<\/p>\n","protected":false},"excerpt":{"rendered":"

ETIOPATOGENEZA KAROTIDNE BOLESTI 3.2. EDEM MOZGA U ISHEMIJI MOZGA Edem mozga je porast zapremine tkiva usled pove\u0107anja sadr\u017eaja te\u010dnosti u njemu. Edem mozga tokom cerebralne ishemije mo\u017ee biti citotoksi\u010dni i vazogeni. Citotoksi\u010dni (metaboli\u010dki) edem mozga nastaje intracelularnom akumulacijom vode, a krvno-mo\u017edana barijera je neo\u0161te\u0107ena. Vazogeni edem je posledica promena na krvnim sudovima koje omogu\u0107avaju prolaz […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1997","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\n3.2. EDEM MOZGA U ISHEMIJI MOZGA - KAROTIDNA HIRURGIJA<\/title>\n<meta name=\"description\" content=\"Edem mozga je porast zapremine tkiva usled pove\u0107anja sadr\u017eaja te\u010dnosti u njemu. Edem mozga tokom cerebralne ishemije mo\u017ee biti citotoksi\u010dni i vazogeni.Citotoksi\u010dni (metaboli\u010dki) edem mozga nastaje intracelularnom akumulacijom vode, a krvno-mo\u017edana barijera je neo\u0161te\u0107ena.Vazogeni edem je posledica promena na krvnim sudovima koje omogu\u0107avaju prolaz proteina i sastojaka krvi kroz lediranu krvno-mo\u017edanu barijeru.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.karotidnahirurgija.com\/?page_id=1997\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"3.2. EDEM MOZGA U ISHEMIJI MOZGA - KAROTIDNA HIRURGIJA\" \/>\n<meta property=\"og:description\" content=\"Edem mozga je porast zapremine tkiva usled pove\u0107anja sadr\u017eaja te\u010dnosti u njemu. 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