“Does the brain always swell? How do you know if the brain is swelling? Doesn’t the CT scan show swelling?
Is it possible that the person’s brain did not swell because of the use of the drug manitol (protocol treatment
in all ICU’s)? Is the chemical released if there is no swelling? If a person didn’t need a shunt, can we assume
there was no swelling?
Pretty much all tissues in the body swell when traumatized. They also require more oxygen to heal. The brain
is unique in that it rests inside a bone case, so when it swells, it experiences more trauma.
The more damage the brain receives, the more it swells. This is caused by leakage from blood vessels. When
the brain swells, because it is housed inside the skull, it has no room to expand. This leads to a rise in
pressure within the brain. This rise in pressure rapidly equals the arterial pressure thereby affecting the blood
flow to the brain. This diffuse pressure which decreases blood flow affects the ability of the cells within the
brain to metabolize properly; the cells are unable to eliminate toxins which then accumulate. ”

Minnesota Brain Injury Alliance