The effect of skull and dura on brain volume regulation after hypo- and hyperosmolar fluid treatment

Neurosurgery
A KunczM Bodosi

Abstract

This study was performed to determine the response of brain water and electrolytes to acute hypo-osmolality and hyperosmolality in animals with intact skulls and dura, in comparison with those subjected to extensive bilateral or unilateral craniectomy and opening of the dura. In rats, 4 to 5 weeks after extensive unilateral or bilateral craniectomy and opening of the dura, a 50-mOsm/kg decrease in plasma osmolality was produced by systemic administration of distilled water ("water intoxication"), or a 28-mOsm/kg increase in plasma osmolality was produced by systemic administration of either 1 M NaCl or 1 M mannitol in 0.34 M NaCl. Tissue water, Na. and K contents were determined after 120 minutes. Tissue water accumulation or water loss was proportional to the decrease or increase in plasma osmolality. The tissue water accumulation after "water intoxication," however, was less (40% of the predicted value) than that predicted for ideal osmotic behavior. The brain tissue was also found to shrink less than predicted on the basis of ideal osmotic behavior (40% of the predicted value after mannitol treatment, and 60% after NaCl administration). This nonideal osmotic response of the brain tissue is consistent with the finding in othe...Continue Reading

Citations

Jan 1, 1993·Acta neurochirurgica·T Dóczi
Jun 24, 1998·Anesthesiology·M L McManus, S G Soriano
Jul 18, 2006·The American Journal of Medicine·Allen I Arieff
Jun 8, 2001·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·B OztaşM Kaya

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