Vasogenic cerebral oedema refers to a type of cerebral oedema in which the blood brain barrier (BBB) is disrupted (cf. cytotoxic cerebral oedema, where the blood-brain barrier remains intact). It is an extracellular oedema which mainly affects the white matter via leakage of fluid from capillaries.
The causes are diverse, including neoplasm, infection, inflammation, haemorrhage, subacute arterial infarct, and venous infarct4.
It is most frequently seen around brain tumours (both primary and secondary) and cerebral abscesses, though some vasogenic oedema may be seen around maturing cerebral contusion and cerebral haemorrhage.
If the oedema is bilateral and more widespread in particular then posterior reversible encephalopathy syndrome (PRES) should also be considered.
Radiographic features
CT
grey-white matter differentiation is maintained and the oedema involves mainly white matter, extending in a finger-like fashion
secondary effects of vasogenic oedema are similar to cytotoxic oedema, with effacement of cerebral sulci, with or without midline shift
MRI
hyperintense T2 and FLAIR signals, which do not show restricted diffusion 2 (cf. cytotoxic cerebral oedema, which shows diffusion restriction)
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