L Toxic Encephalopathy

Although a wide spectrum of substances have toxic effects that can ultimately result in cerebral edema, a direct causal relationship has been established for only a few toxins of clinical significance. Children and adolescents appear to be particularly vulnerable to these toxic exposures. Adolescents ingesting large doses of vitamin A may develop pseudotumor cerebri and visual loss. Organic tin compounds used for the treatment of furunculosis and the use of hexachlor-ophene as a disinfectant may precipitate cytotoxic edema. Acute intoxication with aluminum, copper, or zinc may mimic dialysis disequilibrium. The majority of substances have been associated with cytotoxic edema, although lead encephalopathy is characterized by diffuse vasogenic edema. Lead encephalopathy causes diffuse vascular injury followed by extravasation of protein-rich fluid into the extracellular space. These changes correlate with the diffuse enhancement noted on contrast computed tomography (CT).

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