Chemical shift imaging of mannitol in acute cerebral ischemia. Case report.
The effectiveness of mannitol for the treatment of cerebral edema after stroke has long been debated, and the diffusion of mannitol through a disrupted blood-brain barrier has been the focus of many contradictory studies. The authors present a unique case in which chemical shift imaging was used to demonstrate the accumulation of mannitol in an area of stroke underlying a subdural hematoma in a patient with end-stage renal disease being treated with hemodialysis. A metabolite map for the xenobiotic mannitol was created from the data and demonstrated the accumulation of mannitol when hemodialysis was interrupted prematurely. Metabolite maps were also used to show removal of the mannitol with the reestablishment of hemodialysis. It is concluded that mannitol can accumulate in an area of infarction, and that chemical shift imaging can be used to illustrate this process.
Maioriello
Anthony V
AV
Division of Neurosurgery, University of Texas Medical Branch, Galveston 77555-0517, USA.
Chaljub
Gregory
G
Nauta
Haring J W
HJ
Lacroix
Michel
M
D000208:Acute Disease; D001929:Brain Edema / Q000188:drug therapy / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy* / Q000473:pathology*; D004234:Diuretics, Osmotic / Q000008:administration & dosage*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed
D004234:Diuretics, Osmotic; D008353:Mannitol