OBJECTIVE: Repeated administration of mannitol in the setting of large hemispheric infarction is a controversial and poorly defined therapeutic intervention. This study was performed to examine the effects of multiple-dose mannitol on a brain edema after large hemispheric infarction. METHODS: A middle cerebral artery was occluded with the rat suture model for 6 hours and reperfused in 22 rats. The rats were randomly assigned to either control (n=10) or the mannitol-treated group (n=12) in which intravenous mannitol infusions (0.8 g/kg) were performed six times every four hours. After staining a brain slice with 2,3,5-triphenyltetrazolium chloride, the weight of hemispheres, infarcted (IH) and contralateral (CH), and the IH/CH weight ratio were examined, and then hemispheric accumulation of mannitol was photometrically evaluated based on formation of NADH catalyzed by mannitol dehydrogenase. RESULTS: Mannitol administration produced changes in body weight of -7.6+/-1.1%, increased plasma osmolality to 312+/-8 mOsm/L. It remarkably increased weight of IH (0.77+/-0.06 gm versus 0.68+/-0.03 gm : p<0.01) and the IH/CH weight ratio (1.23+/-0.07 versus 1.12+/-0.05 : p<0.01). The photometric absorption at 340 nm of the cerebral tissue in the mannitol-treated group was increased to 0.375+/-0.071 and 0.239+/-0.051 in the IH and CH, respectively from 0.167+/-0.082 and 0.162+/-0.091 in the IH and CH of the control group (p<0.01). CONCLUSION: Multiple-dose mannitol is likely to aggravate cerebral edema due to parenchymal accumulation of mannitol in the infarcted brain tissue.
OBJECTIVE: Repeated administration of mannitol in the setting of large hemispheric infarction is a controversial and poorly defined therapeutic intervention. This study was performed to examine the effects of multiple-dose mannitol on a brain edema after large hemispheric infarction. METHODS: A middle cerebral artery was occluded with the rat suture model for 6 hours and reperfused in 22 rats. The rats were randomly assigned to either control (n=10) or the mannitol-treated group (n=12) in which intravenous mannitol infusions (0.8 g/kg) were performed six times every four hours. After staining a brain slice with 2,3,5-triphenyltetrazolium chloride, the weight of hemispheres, infarcted (IH) and contralateral (CH), and the IH/CH weight ratio were examined, and then hemispheric accumulation of mannitol was photometrically evaluated based on formation of NADH catalyzed by mannitol dehydrogenase. RESULTS:Mannitol administration produced changes in body weight of -7.6+/-1.1%, increased plasma osmolality to 312+/-8 mOsm/L. It remarkably increased weight of IH (0.77+/-0.06 gm versus 0.68+/-0.03 gm : p<0.01) and the IH/CH weight ratio (1.23+/-0.07 versus 1.12+/-0.05 : p<0.01). The photometric absorption at 340 nm of the cerebral tissue in the mannitol-treated group was increased to 0.375+/-0.071 and 0.239+/-0.051 in the IH and CH, respectively from 0.167+/-0.082 and 0.162+/-0.091 in the IH and CH of the control group (p<0.01). CONCLUSION: Multiple-dose mannitol is likely to aggravate cerebral edema due to parenchymal accumulation of mannitol in the infarcted brain tissue.
Authors: Harold P Adams; Gregory del Zoppo; Mark J Alberts; Deepak L Bhatt; Lawrence Brass; Anthony Furlan; Robert L Grubb; Randall T Higashida; Edward C Jauch; Chelsea Kidwell; Patrick D Lyden; Lewis B Morgenstern; Adnan I Qureshi; Robert H Rosenwasser; Phillip A Scott; Eelco F M Wijdicks Journal: Stroke Date: 2007-04-12 Impact factor: 7.914
Authors: Vasiliki Pappa; Karl Seydel; Sanchit Gupta; Catherine M Feintuch; Michael J Potchen; Samuel Kampondeni; Adam Goldman-Yassen; Mike Veenstra; Lillie Lopez; Ryung S Kim; Joan W Berman; Terrie Taylor; Johanna P Daily Journal: Malar J Date: 2015-12-21 Impact factor: 2.979