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Hypertonic saline and mannitol are the main osmotic agents in use, while loop diuretics can aid in the removal of the excess fluid pulled out of the brain. [1] [3] [7] [43] Hypertonic saline is a highly concentrated solution of sodium chloride in water and is administered intravenously. [3]
Hypertonic saline can improve ICP by reducing the amount of cerebral water (swelling), though it is used with caution to avoid electrolyte imbalances or heart failure. [ 10 ] [ 100 ] [ 101 ] Mannitol , an osmotic diuretic , [ 10 ] appears to be as effective as hypertonic saline at reducing ICP; [ 102 ] [ 103 ] [ 100 ] [ 104 ] however, some ...
Hypertonic Saline which contains sodium chloride works in regulating ICP, intravascular volume and cardiac output without causing significant diuresis, but there are theoretical side effects ranging from neurological complications to subdural hematoma. Hypertonic saline solution has been choice of neuro critical care for the past few years. [1]
Intracranial hemorrhage (ICH), also known as intracranial bleed, is bleeding within the skull. [1] Subtypes are intracerebral bleeds ( intraventricular bleeds and intraparenchymal bleeds ), subarachnoid bleeds , epidural bleeds , and subdural bleeds .
The presence of cerebral edema, or other moderate to severe symptoms, may necessitate intravenous hypertonic saline administration with close monitoring of the serum sodium levels to avoid overcorrection. [2] SIADH was originally described in 1957 in two people with small-cell carcinoma of the lung. [3]
Treatments may involve controlling elevated intracranial pressure. This can include sedation, paralytics, cerebrospinal fluid diversion. Second-line alternatives include decompressive craniectomy (Jagannathan et al. found a net 65% favorable outcomes rate in pediatric patients), barbiturate coma, hypertonic saline, and hypothermia.
In contrast, the most proximal occlusions result in widespread effects that can lead to significant cerebral edema, increased intracranial pressure, loss of consciousness and could even be fatal. [1] In such occasions, mannitol (osmotic diuretic) or hypertonic saline are given to draw fluid out of the edematous cerebrum to minimise secondary ...
Intracerebral hemorrhage (ICH), also known as hemorrhagic stroke, is a sudden bleeding into the tissues of the brain (i.e. the parenchyma), into its ventricles, or into both. [ 3 ] [ 4 ] [ 1 ] An ICH is a type of bleeding within the skull and one kind of stroke (ischemic stroke being the other).