Skip to main content
SpringerLink
Log in

The immediate and long-term effects of mannitol and glycerol

A comparative experimental study

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

A prolonged experimental situation of focal vasogenic oedema, producing mild intracranial hypertension, was developed. The aim was to study the immediate and long-term effects of repeated infusions of mannitol and glycerol on intracranial pressure (ICP) and cerebral blood flow (CBF).

Eighteen goats were operated on twice to implant: an epidural latex balloon in each cerebral hemisphere to measure ICP; an electromagnetic flowmeter around both internal maxillary arteries (the only cerebral blood input), after tying the extracranial branches, to measure the CBF; and two femoral catheters to measure blood pressure (BP) and for intravenous infusion (IV). Three groups of 6 goats each were formed: A) control; the BP and bilateral ICPs and CBFs were recorded under basal conditions and every 4 hours for 3 days after a cold injury (CI) was provoked; B) 20% mannitol solution 1 g/kg body weight injected every 12 hr starting at 24 hr post-CI; and C) 10,1% glycerol solution 0.5 g/kg body weight, administered as mannitol.

Glycerol, as compared to mannitol, presents the following major differences among its immediate post infusion effects: a lesser decrease in ICP, but no rebound phenomenon; lesser elevation of BP; CBF increases more gradually and constantly. Long-term effects with mannitol consisted of a rebound phenomenon observed in ICP during the last 12 hr. In all 3 groups, it was observed that CBF increases in relation to the ICP level.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Allweis C, Coxon RV, Magnes Vet al (1972) Fate of 14C-glycerol in the perfused cat brain. J Neurosurg 19: 547–550

    Google Scholar 

  2. Bovet D, Cantore GP, Guidetti Bet al (1961) Il glicerolo in neurochirurgia. Nuovo terapia dell-ipertensione endocranica. Gazz Int Med Chir 66: 3021–3034

    Google Scholar 

  3. Cantore GP, Guidetti B, Virno M (1963) Oral glycerol for the reduction of intracranial pressure. J Neurosurg 21: 278–283

    Google Scholar 

  4. Cooper IS, Lee A (1961) Cryothalamectomy-hypothermia congelation. Technical advance in basal ganglion surgery. Preliminary report. J Am Geriatr Soc 9: 714–718

    Google Scholar 

  5. Coroneos NJ, McDowall DG, Gibson RMet al (1973) Measurement of extradural pressure and its relationship to other intracranial pressure. An experimental and clinical study. J Neurol Neurosurg Psychiatry 6: 514–522

    Google Scholar 

  6. Dewey RC, Pieper HP, Hunt WE (1974) Experimental cerebral hemodynamics. Vasomotor tone, critical closing pressure and vascular bed resistance. J Neurosurg 41: 597–606

    PubMed  Google Scholar 

  7. García Sola R (1978) Modelo experimental de estudio del edema cerebral en animal sin anestesiar. Tesis Doctoral. Universidad Autónoma de Madrid.

  8. García Sola R, Vaquero J, Cabezudo J, Bravo G (1980) Evolution of intracranial pressure and cerebral blood flow in cryogenic cerebral edema. In: Shulman Ket al (eds) Intracranial pressure IV. Springer, Berlin Heidelberg New York Tokyo, pp 268–271

    Google Scholar 

  9. Gobiet W, Grote W, Bock WJ (1975) The relation between intracranial pressure, mean arterial pressure and cerebral blood flow in patients with severe head injury. Acta Neurochir (Wien) 32: 13–24

    Google Scholar 

  10. Hashi K, Meyer JS, Shinmaru Set al (1972) Effect of glycerol and intracarotid phenoxybenzamine on cerebral hemodynamics and metabolism after experimental subarachnoid hemorrhage. J Neurol Sci 17: 23–28

    PubMed  Google Scholar 

  11. Hoppenstein R (1965) A device for measuring intracranial pressure. Lancet 1: 90–91

    Google Scholar 

  12. Javid M, Settlage P (1956) Effects of urea on cerebrospinal fluid pressure in human subjects. Preliminary report. J Am Med Assoc 10: 943–949

    Google Scholar 

  13. Johnston IH, Paterson A, Harper AMet al (1972) The effect of mannitol on intracranial pressure and CBF. In: Brock M, Dietz H (eds) Intracranial pressure. Springer, New York, pp 176–180

    Google Scholar 

  14. Johnston IH, Harper AM (1973) The effect of mannitol on cerebral blood flow. An experimental study. J Neurosurg 38: 461–471

    PubMed  Google Scholar 

  15. Johnston I (1975) Intracranial pressure changes after head injury. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 23. North-Holland Publ Co, Amsterdam, pp 199–222

    Google Scholar 

  16. Kassell N, Bauman KW, Hitchon PWet al (1981) Influence of continuous high dose infusion of mannitol on cerebral blood flow in normal dogs. Neurosurgery 9: 283–286

    PubMed  Google Scholar 

  17. Klatzo I (1967) Neuropathological aspects of brain edema. J Neuropathol Exp Neurol 26: 1–14

    PubMed  Google Scholar 

  18. Klatzo I (1973) Pathophysiology of brain edema: pathological aspects. In: Schürmann K, Brock M (eds) Advances in neurosurgery. Brain edema. Springer, New York, pp 1–4

    Google Scholar 

  19. Kuhner A, Roquefeuil B, Viguie Eet al (1973) The influence of high and low dosages of mannitol 25% in the therapy of cerebral edema. Comparative study with monitoring of intraventricular pressure. In: Schürmann K, Brock M (eds) Advances in neurosurgery I. Brain edema. Springer, New York, pp 81–91

    Google Scholar 

  20. Lazorthes G, Campan L (1974) Brain edema. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 16. North Holland Publ Co, Amsterdam, pp 186–208

    Google Scholar 

  21. Leech P, Miller JD (1975) The effect of mannitol, steroids and hypocapnia on the intracranial volume/pressure response. An experimental and clinical study. In: Lundberg N, Ponten U, Brock M (eds) Intracranial pressure II. Springer, New York, pp 361–364

    Google Scholar 

  22. Lewin W (1966) The management of head injuries. Williams & Wilkins, Baltimore

    Google Scholar 

  23. Long DM, Hartman JF, French LA (1967) Ultrastructural substrates of experimental cerebral edema. In: Klatzo I, Seitelberger F (eds) Brain edema. Springer, New York, pp 419–443

    Google Scholar 

  24. Long DM, Maxwell RE, Choi KSet al (1972) Multiple therapeutic approach in the treatment of brain edema induced by a standard cold lesion. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, New York, pp 87–94

    Google Scholar 

  25. Matakas F, Waechter RV, Knupling Ret al (1975) Increase in cerebral perfusion pressure by arterial hypertension in brain swelling. A mathematical model of the volume-pressure relationship. J Neurosurg 5: 282–289

    Google Scholar 

  26. McQueen JD, Jeanes LD (1964) Dehydration and rehydration of the brain with hypertonic urea and mannitol. J Neurosurg 21: 118–128

    PubMed  Google Scholar 

  27. Meyer JS, Charney JZ, Rivera VM et al (1971) Treatment with glycerol of cerebral edema due to acute cerebral infarction. Lancet 2: 993–997

    PubMed  Google Scholar 

  28. Meyer JS, Shinmaru K, Ohuchi Tet al (1914) Cerebral metabolic effects of glycerol infusion in diabetics with stroke. J Neurol Sci 21: 1–22

    Google Scholar 

  29. Miller JD, Leech P (1975) The effects of mannitol and steroid therapy on intracranial volume/pressure relationships in patients. J Neurosurg 42: 274–281

    PubMed  Google Scholar 

  30. Newkirk TA, Tourtellotte WW, Reinglass JL (1972) Prolonged control of increased intracranial pressure with glycerin. Arch Neurol 27: 95–96

    PubMed  Google Scholar 

  31. Ott EO, Mathew NT, Meyer JS (1974) Redistribution of regional cerebral blood flow after glycerol infusion in acute cerebral infarction. Neurology (Minn) 24: 1117–1126

    Google Scholar 

  32. Pappius HM (1967) Biochemical studies in experimental cerebral edema. In: Klatzo I, Seitelberger F (eds) Brain edema. Springer, New York, pp 445–460

    Google Scholar 

  33. Pappius HM, McCann WP (1969) Effects of steroids on cerebral edema in cats. Arch Neurol (Chic) 20: 207–216

    Google Scholar 

  34. Reiman C, Lluch S, Glick G (1972) Development and evaluation of an experimental model for the study of the cerebral circulation in the unanaesthetized goat. Stroke 3: 322–328

    PubMed  Google Scholar 

  35. Shenkin HA, Goluboff G, Haft H (1962) The use of mannitol for the reduction of intracranial pressure in intracranial surgery. J Neurosurg 19: 897–901

    PubMed  Google Scholar 

  36. Troupp H, Valtonen S, Vapalahti M (1971) Intraventricular pressure after administration of dehydrating agents to severely brain-injured patients. Is there a rebound phenomenon? Acta Neurochir (Wien) 24: 89–95

    Google Scholar 

  37. Virno M, Della Rocca L, Peroci-Giraldi Jet al (1966) Scomparsa dell ematuria provocata del glicerolo endovenoso nel coniglio mediante associazearse glicerolo-ascorbato di sodio. Gazz Int Med Chir 71: 1160

    Google Scholar 

  38. Wald SL, McLaurin RL (1982) Oral glycerol for the treatment of traumatic intracranial hyerptension. J Neurosurg 56: 323–331

    PubMed  Google Scholar 

  39. Wise BL, Chater N (1961) Effects of mannitol on cerebral fluid pressure. The action of hypertonic mannitol solution and urea compared. Arch Neurol Psychiat (Chic) 4: 200–202

    Google Scholar 

  40. Zattoni J, Siani C, Semino C (1973) Some technical factors affecting the intracranial pressure recorded by epidural spaceoccupying devices. Acta Neurochir (Wien) 28: 353–358

    Google Scholar 

  41. Zilversmit DB, McCandless EL (1957) Fate of intravenously administered glycerol. Proc Soc Exp Biol Med 95: 755–757

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. R. García-Sola

    Present address: Department of Neurosurgery, Hospital de la Princesa, Spain

Authors and Affiliations

  1. Department of Neurosurgery, Hospital de la Princesa, Spain

    P. Pulido & P. Capilla

  2. Department of Experimental Surgery, Hospital Puerta de Hierro, Autonomous University, Madrid, Spain

    R. García-Sola, P. Pulido & P. Capilla

Authors
  1. R. García-Sola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Pulido
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Capilla
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

García-Sola, R., Pulido, P. & Capilla, P. The immediate and long-term effects of mannitol and glycerol. Acta neurochir 109, 114–121 (1991). https://doi.org/10.1007/BF01403005

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01403005

Keywords

Search

Navigation