Abstract:

Traumatic brain injury (TBI) is associated with high rates of mortality and morbidity. Early changes include parenchymal damage, intracerebral hemorrhage, axonal injury, and so on, while secondary injuries that develop over time include cerebral edema, inflammation reaction, blood-brain barrier (BBB) disruption, oxidative stress, excitotoxicity, and mitochondrial or metabolic dysfunction. Among these, cerebral edema is the serious complication of TBI and is the primary contributor to poor clinical outcomes. The mechanisms underlying its development and potential treatments are major current research focuses. The treatment includes glucocorticoids, hypertonic saline or diuretic, as well as surgical treatment, but none can effectively alleviate the condition or improve the prognosis. This article reviews the key molecular mechanisms, pathological features and emerging therapies for cerebral edema to enhance clinical understanding of its role in TBI. Such insights are essential for improving both prevention and precision treatment strategies.

Key words: Brain injuries, traumatic, Brain edema, Pathology, Traditional Chinese medicine therapy, Glymphatic system, Aquaporin 4, Adiponectin, Vascular endothelial growth factors, Review

摘要：

颅脑创伤具有较高病死率和病残率，早期改变包括脑实质损伤、脑出血和轴突损伤等，逐渐发生的继发性损伤包括脑水肿、炎症反应、血脑屏障损伤、氧化应激、兴奋性毒性及线粒体和代谢功能障碍。脑水肿是颅脑创伤的严重并发症，是最终引起临床预后不良的主要原因，其潜在治疗和发展机制是当前主要研究重点。治疗方案包括糖皮质激素、高渗盐水或利尿剂及手术治疗等，但均不能达到有效缓解病情、改善预后之目的。本文拟综述创伤性脑水肿的分子机制、病理学特征和新型治疗靶点，以提高对创伤性脑水肿发病机制的认知，为临床治疗提供新思路。

关键词: 脑损伤，创伤性, 脑水肿, 病理学, 中医药疗法, 神经胶细胞类淋巴系统, 水通道蛋白质4, 脂联素, 血管内皮生长因子类, 综述