The Effect of Dexamethasone and Diuretics on Peritumor Brain Edema: Comparative Study of Tissue Water Content and CT

Meinig, G.; Aulich, A.; Wende, S.; Reulen, H. J.

doi:10.1007/978-3-642-66524-0_46

Cited by 30 publications

(10 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, Reulen et al 27 reported direct evidence for the effectiveness of dexamethasone in brain edema associated with brain tumors by measuring water, sodium and potassium content of biopsied peritumoral edematous brain tissue. Meinig et al, 28 using planimetry of peritumoral low density areas in CT scans, found dexamethasone to be effective in peritumoral brain edema. However, Kullberg™ measured the intracranial pressure of traumatic brain edema patients and found that steroid treatment had little or no effect on the continuous elevation of intracranial pressure, while it had some effect on the high pressure pattern which showed plateau waves.…”

Section: Discussionmentioning

confidence: 99%

Effect of steroid on ischemic brain edema. Analysis of cytotoxic and vasogenic edema occurring during ischemia and after restoration of blood flow.

Ito¹,

Ohno²,

Suganuma³

et al. 1980

Stroke

View full text Add to dashboard Cite

SUMMARY Mongolian gerbils were obserred for the effects of /9-methasone on iscnemic brain edema which developed during ischemia or after blood flow restoration.The severity of brain edema was determined by measuring water content of the iscbemlc cerebral hemisphere, using the wet and dry methods. Sodium and potassium ions were extracted from homogenized brains with 0.75N HNO, and ion concentration measured by flame photometry. Passage of RISA from blood into the cerebral parenchyma, as an indicator of blood-brain barrier change, was determined with a 7-scintillation counter.In the cytotoxic edema model, animals were killed after 9 h permanent ischemia or 3 h after 1 h ischemia. In the simultaneous cytotoxic and vasogenic edema model, the animals were killed either 20 h or 3 days following 1 h ischemia, or 3 h after blood flow restoration following 6 h ischemia.Steroid treatment was ineffective in ischemic brain edema of the cytotoxic or vasogenic type. Stroke, Vol 11, No 2, 1980

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of steroid on ischemic brain edema. Analysis of cytotoxic and vasogenic edema occurring during ischemia and after restoration of blood flow.

Ito¹,

Ohno²,

Suganuma³

et al. 1980

Stroke

View full text Add to dashboard Cite

show abstract

“…1 * 8 In this study, which also involves experimental work with the rhesus monkey, the mean density of the edematous tissue ranges from 11.1 h to 16.4 h. In a biopsy study, where the presence of edema was chemically verified, a mean of 12.1 h with a range of 9.5 h to 13.7 h, is reported. 188 In an in vitro study of formalin fixed brains with hemorrhages and with metastatic tumors, a mean density of 12.6 h with a range of 8.3 h to 16.6 h is found. 187 This tissue also shows an increased water content and a diminished specific gravity.…”

Section: Mmentioning

confidence: 96%

“…The edematous white matter surrounding tumors has a dry weight of 20.1 gm%. 188 This gives for edematous tissue a predicted attenuation number of 10.4 h, assuming that the change is due purely to dilution. The actual measured attenuation numbers for two samples of isolated edematous tissue are 8.8 h and 11.1 h. 180 Because the in vivo attenuation numbers cited are generally higher than the predicted value of 10.4 h, one must consider the possible reasons for this discrepancy.…”

Section: Mmentioning

confidence: 99%

“…188 The value for normal white matter is 60.0 mEq/kilo wet weight. 111 Insofar as edema fluid has a dry mass, this is included in the measured dry mass of edematous tissue and influences the attenuation number according to the slope of the line describing the dilutional effect ( fig.…”

Section: Mmentioning

confidence: 99%

“…Using the latter technique, peritumor edema was reported to decrease over a period of weeks following treatment with steroids and furosemide. 188 A third method consists of measuring with computer-assisted techniques the density of concentric rings around the lesion. 199 The CT scan provides the means to measure cerebral edema in the living patient; the techniques require further improvement.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Report of Joint Committee for Stroke Resources. IV. Brain edema in stroke.

Katzman¹,

Clasen²,

Klatzo³

et al. 1977

Stroke

209

View full text Add to dashboard Cite

SUMMARY A classification of brain edema is provided as well as an extensive review of the animal models from which we have derived most of the basic information we have about the formation and resolution of edema. The clinical aspects of cerebral edema in stroke are discussed and also modern methods for identifying cerebral edema in the human. Attention is given to computed tomography and enhanced CT and advances in their application to this condition.Treatment of cerebral edema in the stroke patient using glycerol, dextran 40, mannitol, steroids, and other drugs is discussed and the need pointed out for controlled clinical trials of the therapeutic effectiveness of these agents.THE IMPORTANCE of brain swelling in the pathogenesis of stroke assumes growing significance as physicians increase their understanding of cerebrovascular diseases and their attempts to provide treatment. For example, a recent report 1 shows that in 32 of 100 patients who died as the result of cerebral infarction, transtentorial herniation was considered to be the most serious factor contributing to death. In the experience of most clinicians, a "swollen brain" can be demonstrated as well in a substantial number of patients who come to autopsy as a result of cerebral hemorrhage.The study group members appreciate fully the difficulties involved in understanding and interpreting current knowledge of cerebral edema pathogenesis gained from animal experimentation. Nevertheless, the basic information derived from a variety of animal models and reported in detail in the first pages of this report is considered essential to understanding the cerebrovascular events occurring in man. The ultimate objectives are to prevent cerebral edema wherever possible and to treat the condition when it develops, with the expectation of reducing the morbidity and mortality resulting from this complication. Classification of Cerebral EdemaCerebral edema is defined as an increase in brain tissue volume resulting from an increase in its fluid content.2 It must at all times be differentiated from brain engorgement caused by an increase in the volume of blood within a region of the brain 3 and from brain swelling due to intracerebral hemorrhage.• A priori, one might suppose that edema associated with cerebrovascular lesions would be primarily of the vasogenic type, since both overt injury to blood vessels and often a discrete focal brain lesion are present. However, experimentally, the increase in tissue volume and water is found usually to reach a peak prior to the extravasation of protein or of BBB indicators. Clinically, swelling in and around an area of infarction may be present before the radionuclide (RN) scan used to monitor BBB leakage becomes positive. This evidence suggests that brain edema due to focal ischemia begins as a cytotoxic type and is followed by a vasogenic edema. But the pathophysiology of this edema and its pattern of development are sufficiently specific to warrant a separate classification as ischemic brain edema. Biochemical Measures of Exp...

show abstract