Effects of mannitol and steroid therapy on intracranial volume-pressure relationships in patients

• Published in: Journal of neurosurgery Vol. 42; no. 3; p. 274
• Main Authors: Miller, J D, Leech, P
• Format: Journal Article
• Language: English
• Published: United States 01.03.1975
• Subjects: Betamethasone - administration & dosage; Betamethasone - therapeutic use; Brain Neoplasms - complications; Cerebral Ventricles - anatomy & histology; Cerebrospinal Fluid; Cerebrovascular Disorders - complications; Craniocerebral Trauma - complications; Humans; Hydrocephalus - drug therapy; Hydrocephalus - etiology; Injections, Intramuscular; Intracranial Pressure - drug effects; Mannitol - therapeutic use; Pseudotumor Cerebri - drug therapy
• ISSN: 0022-3085
• DOI: 10.3171/jns.1975.42.3.0274

The intracranial volume-pressure response was measured in 61 patients undergoing continous monitoring of intraventicular pressure. This test, which determlnes the increase in intracranial pressure induced by an addition of 1 ml in ventricular CSF volume in 1 sencond, yields information concerning spatial compensation in patients with intracranial space-occupying processes. On the basis of variability tests, a change in volume-pressure response of 2 mm Hg/ml was accepted as significant. Pronounced enlargement of the ventricles interferes with the test. In patients with intracranial hypertension, intravenous mannitol (0.5gm/kg) and intramuscular betamethasone (26 mg) both reduce the volume-pressure response significantly more than they reduce intracranial pressure. This suggests that these agents favorably alter the configuration of the volume-pressure curve.