Die Wirkung der Acetazolamid-induzierten, endogenen Volumenbelastung des zerebrospinalen Systems auf den intrakraniellen Druck. DIAMOX®-Wirkung auf den intrakraniellen Druck (ICP)*

Höll, K.; He, Heissler; Nemati, N.; Mr, Gaab; Haubitz, B.; Becker, H

doi:10.1055/s-2008-1053550

Cited by 3 publications

(1 citation statement)

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“…Furthermore, in traumatic brain injury (TBI) experiments, antiedematous, and neuroprotective effects of ACZ treatment could be demonstrated, and its therapeutic potential has been postulated (3, 6, 7). While ACZ has been applied for detection of impaired vascular autoregulation in mild TBI (23), the vasoactive effect of ACZ may play also negative role in treatment of severe head injury: ACZ increases intracranial blood volume and may therefore, according to Monro-Kellie doctrine, cause ICP increase (17, 24, 25).…”

Section: Introductionmentioning

confidence: 99%

Brain Edema Formation and Functional Outcome After Surgical Decompression in Murine Closed Head Injury Are Modulated by Acetazolamide Administration

et al. 2019

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Acetazolamide (ACZ), carbonic anhydrase inhibitor, has been successfully applied in several neurosurgical conditions for diagnostic or therapeutic purposes. Furthermore, neuroprotective and anti-edematous properties of ACZ have been postulated. However, its use in traumatic brain injury (TBI) is limited, since ACZ-caused vasodilatation according to the Monro-Kellie doctrine may lead to increased intracranial blood volume / raise of intracranial pressure. We hypothesized that these negative effects of ACZ will be reduced or prevented, if the drug is administered after already performed decompression. To test this hypothesis, we used a mouse model of closed head injury (CHI) and decompressive craniectomy (DC). Mice were assigned into following experimental groups: sham, DC, CHI, CHI+ACZ, CHI+DC, and CHI+DC+ACZ ( n = 8 each group). 1d and 3d post injury, the neurological function was assessed according to Neurological Severity Score (NSS) and Beam Balance Score (BBS). At the same time points, brain edema was quantified by MRI investigations. Functional impairment and edema volume were compared between groups and over time. Among the animals without skull decompression, the group additionally treated with acetazolamide demonstrated the most severe functional impairment. This pattern was reversed among the mice with decompressive craniectomy: CHI+DC treated but not CHI+DC+ACZ treated animals showed a significant neurological deficit. Accordingly, radiological assessment revealed most severe edema formation in the CHI+DC group while in CHI+DC+ACZ animals, volume of brain edema did not differ from DC-only animals. In our CHI model, the response to acetazolamide treatment varies between animals with decompressive craniectomy and those without surgical treatment. Opening the cranial vault potentially creates an opportunity for acetazolamide to exert its beneficial effects while vasodilatation-related risks are attenuated. Therefore, we recommend further exploration of this potentially beneficial drug in translational research projects.

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Section: Introductionmentioning

confidence: 99%

Brain Edema Formation and Functional Outcome After Surgical Decompression in Murine Closed Head Injury Are Modulated by Acetazolamide Administration

et al. 2019

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P300 and Xenon Computed Tomography Before and After Intravenous Injection of Acetazolamide

Oishi¹,

Mochizuki²,

Hara³

et al. 1995

Archives of Neurology

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Acetazolamide reactivity on cerebral blood flow in patients with subarachnoid haemorrhage

et al. 1991

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Cerebral vasodilatory capacity was evaluated by acetazolamide-activated N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT) in 42 patients with subarachnoid haemorrhage (SAH). A low perfusion area was present in the corresponding region of haematoma seen on the CT and continued to be noted throughout the time courses. Deteriorated acetazolamide reactivity affected by surgical intervention was seen in 100% of the patients who underwent aneurysm repair in the 1st postoperative week, 92% in the second week, 73% in the third week, and 47% in the fourth week. Three patients with acute diffuse brain swelling seen on CT showed intracranial non-filling of 123I-IMP on SPECTs performed on Day 6, and all three died by Day 10. Some low perfusion areas, due to probable vasospasm, were present in 77% of Hunt and Hess grades I and II patients and in 100% of grades III, IV, and V patients throughout their time courses. Overall, low perfusion areas, due to probable vasospasm, were seen in 10 patients (31%) of 32 who underwent SPECT between Day 4 and 8,23 (77%) of 30 between Day 9 and 14, 21 (72%) of 29 between Day 15 and 21, and 11 (48%) of 23 between Day 22 and 28. The results suggest acetazolamide-activated 123I-IMP study is of value in evaluating changes in vasodilatory capacity in SAH patients in the acute and subacute stages.

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Die Wirkung der Acetazolamid-induzierten, endogenen Volumenbelastung des zerebrospinalen Systems auf den intrakraniellen Druck. DIAMOX®-Wirkung auf den intrakraniellen Druck (ICP)*

Cited by 3 publications

References 0 publications

Brain Edema Formation and Functional Outcome After Surgical Decompression in Murine Closed Head Injury Are Modulated by Acetazolamide Administration

Brain Edema Formation and Functional Outcome After Surgical Decompression in Murine Closed Head Injury Are Modulated by Acetazolamide Administration

P300 and Xenon Computed Tomography Before and After Intravenous Injection of Acetazolamide

Acetazolamide reactivity on cerebral blood flow in patients with subarachnoid haemorrhage

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