Brain tissue swelling, known as cerebral oedema, results from brain injury and other traumatic head injuries that can increase intracranial pressure (ICP). Negatively charged molecules within cells create a fixed charge density, which increases intracranial pressure through the Donnan effect. ATP pumps maintain a negative membrane potential even though negative charges leak across the membrane; this action establishes a chemical and electrical gradient.
The negative charge in the cell and ions outside the cell creates a thermodynamic potential; if damage occurs to the brain and cells lose their membrane integrity, ions will rush into the cell to balance chemical and electrical gradients that were previously established. The membrane voltage will become zero, but the chemical gradient will still exist. To neutralize the negative charges within the cell, cations flow in, which increases the osmotic pressure inside relative to the outside of the cell. The increased osmotic pressure forces water to flow into the cell and tissue swelling occurs.