A 62-yrs-old male presents to you with an acute onset of hemiparesis. CT
scan reveals an increase in intracranial fluid. Which solution will be
most effective in reducing intracranial pressure following a large
hemispheric stroke?
A. 150 mmol sodium chloride
B. 250 mmol glycerol
C. 250 mmol glucose
D. 350 mmolmannito
A. 150 mmol sodium chloride
B. 250 mmol glycerol
C. 250 mmol glucose
D. 350 mmolmannito
Ans. D.
Rapid removal of
fluid from the brain can be produced by the administration of a fluid that
increases the osmotic pressure difference between the brain and the cerebral
vessels. The appropriate solution must have a higher osmolarity (that is,
greater than 300 mM) and be composed of a solute that is impermeable to the
blood- brain barrier Of the solutions listed, only urea and mannitol are
hyperosmotic and of these, only mannitol is impermeable to the blood-brain
barrier.
