The Water Content of White Matter After Head Injury in Man

  • Sam Galbraith
  • Enrico Cardoso
  • Jim Patterson
  • Tony Marmarou


Edema, increased cerebral blood volume and outflow obstruction have been suggested as possible causes of raised intracranial pressure (ICP) after head injury. Studies following experimental head injury in animals have produced conflicting results; Tornheim and McLaurin15 found an increase in cerebral water content in the contused hemisphere whereas using a fluid percussion model Corales et al2 were unable to show any increase. While brain water has been measured directly in man3,7,11,12,13,14 it has not been measured after head injury and conclusions about brain water after head injury have been based on indirect measurements utilizing the CT scan1,8. To overcome this and in order to determine the relationship between brain water and intracranial pressure we have measured directly the water content of the white matter of brain tissue taken from severely head injured patients during operation.


Head Injury Brain Edema Cerebral Blood Volume Brain Water Content Diffuse Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bruce DA, Acavi A, Bilanivk L, Dolinskas C, Obrist W, Uzzell B: Diffuse cerebral swelling following head injuries in children: The syndrome of “Malignant brain oedema”. J Neurosurg 54: 170–178 (1981).CrossRefGoogle Scholar
  2. 2.
    Corales RL, Miller JD, Becker DP: Intracranial pressure and brain water content in acute graded experimental cerebral trauma. In: Shulman K, Marmarou A, Miller JD (Eds.). Intracranial Pressure IV, Springer-Verlag, Berlin, 280 (1979).Google Scholar
  3. 3.
    Lanksch W, Oettinger W, Baethmann A, Kazner E: CT findings in brain edema compared with direct chemical analysis of tissue samples. In: Pappius HM, Feindel W (Eds.), Dynamics of Brain Edema. Springer-Verlag, New York, 283–287 (1976).CrossRefGoogle Scholar
  4. 4.
    Marmarou — personal communication.Google Scholar
  5. 5.
    Marmarou A, Poll W, Shulman K, Bhagavan H: A simple gravimetric technique for measurement of cerebral edema. J Neurosurg 49: 530–537 (1978).CrossRefGoogle Scholar
  6. 6.
    Marmarou A, Kiyoaki T, Shulman K: An improved gravimetric measure of cerebral edema. J Neurosurg 56: 246–253 (1982).CrossRefGoogle Scholar
  7. 7.
    Meinig G, Aulich A, Wende S, Reulen HJ: The effect of dexa-methasone and diuretics on peritumor brain edema: comparative study of tissue water content and CT. In: Pappius HM, Feindel W (Eds.), Dynamics of Brain Edema. Springer-Verlag, New York, 301–305 (1976).CrossRefGoogle Scholar
  8. 8.
    Miller JD, Gudeman SK, Kishore PS, Becker DP: Computed tomography in brain edema due to trauma. In: Brain Edema, Cervos-Navarro J, Ferszt R (Eds.). Adv Neurol 28, Raven Press, New York 413–422 (1980).Google Scholar
  9. 9.
    Muirhead EE, Grow MH, Walter AT: Practical observations on the copper sulfate method for determining the specific gravities of whole blood and serum. Surg, Gynecol Obste 82: 405–412 (1946).Google Scholar
  10. 10.
    Nelson SR, Matz ML, Maxwell JA: Use of specific gravity in the measurement of cerebral edema. J Appl Physiol 30: 268–271 (1971).Google Scholar
  11. 11.
    Reulen HJ, Hadjidimos A, Schurmann K: The effect of dexametha-sone on water and electrolyte content and on rCBF in perifocal brain edema in man. In: Reulen HJ, Schurmann K (Eds.), Steroids on Brain Edema. Springer-Verlag, Berlin, 239–252 (1972).CrossRefGoogle Scholar
  12. 12.
    Takagi H, Shapiro K, Marmarou A, Wisoff H: Microgravimetric analysis of human brain tissue: Correlation with computerized tomography scanning. J Neurosurg 54: 797–801 (1981).CrossRefGoogle Scholar
  13. 13.
    Torack RM, Alcala H and Gado M: Water, Specific gravity and histology as determinants of diagnostic computerized cranial tomography (CCT). In: Pappius and Feindel (Eds.), Dynamics of Brain Edema. Springer-Verlag, New York pp 271–277 (1976).CrossRefGoogle Scholar
  14. 14.
    Torack RM, Alvala H, Gado M, Burton R: Correlative assay of computerized cranial tomography (CCT), water content and specific gravity in normal and pathological postmortem brain. J Neuropath Exp and Neurol 35: 385–392 (1976).CrossRefGoogle Scholar
  15. 15.
    Tornheim PA, McLaurin RL: Acute changes in regional brain water content following experimental closed head injury. J Neurosurg 55: 407–413 (1981).CrossRefGoogle Scholar
  16. 16.
    Wood JH: Physiology, pharmacology and dynamics of cerebrospinal fluid. In: Wood JH (Ed.), Neurobiology of Cerebrospinal Fluid. Plenum Press, New York London 6 (1980).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Sam Galbraith
    • 1
  • Enrico Cardoso
    • 1
  • Jim Patterson
    • 1
  • Tony Marmarou
    • 1
  1. 1.Institute of Neurological SciencesSouthern General HospitalGlasgowUK

Personalised recommendations