| Transcranial doppler monitoring of intracranial pressure therapy with mannitol, sorbitol and glycerol in patients with acute stroke. | |
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MedLine Citation:
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PMID: 9813404 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The noninvasive management of the conservative therapy for intracranial pressure (ICP) with hyperosmolar substances is a central problem in the treatment of brain edema. Using transcranial Doppler (TCD), a continuous monitoring of ICP is now possible, because the TCD pulsatility index (PI) intraindividually closely correlates with the level of ICP. PATIENTS AND METHODS: We administered an ICP-lowering treatment 113 times in 10 patients with intracranial bleeding or ischemic stroke who also had signs of elevated ICP in the computer tomogram. The treatment was carried out over a period of 9 days, using 50 g each of intravenous sorbitol (n = 38) and mannitol (n = 32) or oral glycerol (n = 43). RESULTS: PI was significantly lowered between 20.0 and 23.9% (p < 0.01) by all substances in the affected and unaffected sides. The differences between the three substances and the differences between the affected and unaffected sides were not significant. The duration of the therapeutic effect of glycerol (190 +/- 41 min) was significantly longer (p < 0.01) than that of sorbitol (150 +/- 28 min) or mannitol (130 +/- 20 min). The duration of the therapeutic effect was also significantly shorter (p < 0.01) in patients with a high PI (> 1.5). All three substances led to a significant increase (p < 0.01) in minimal (= diastolic) flow velocity (Vmin). The increase was highest for glycerol (56.3 +/-72.6%). SUMMARY: The decrease in PI under therapy was caused by an increase in Vmin. This indicates that ICP therapy with hyperosmolar substances improves brain edema and does not suggest a therapy-induced vasoconstriction. |
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Authors:
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J Treib; S C Becker; M Grauer; A Haass |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European neurology Volume: 40 ISSN: 0014-3022 ISO Abbreviation: Eur. Neurol. Publication Date: 1998 Nov |
Date Detail:
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Created Date: 1999-01-19 Completed Date: 1999-01-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0150760 Medline TA: Eur Neurol Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 212-9 Citation Subset: IM |
Affiliation:
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Department of Neurology, University of the Saarland, Homburg, Germany. nejtre@krzsun.med-rz.uni-sb.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Cerebrovascular Disorders / diagnosis, drug therapy*, physiopathology Female Glycerol / therapeutic use* Humans Intracranial Pressure / drug effects* Male Mannitol / therapeutic use* Middle Aged Monitoring, Physiologic / methods Osmolar Concentration Sorbitol / therapeutic use* Tomography, X-Ray Computed Ultrasonography, Doppler, Transcranial* |
| Chemical | |
Reg. No./Substance:
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50-70-4/Sorbitol; 56-81-5/Glycerol; 69-65-8/Mannitol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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