title: Effect of glycerol on ischemic cerebral edema assessed by magnetic resonance imaging.
abstract: The aim of this study is to assess the anticerebral edema effect of glycerol on a large cerebral infarction with magnetic resonance imaging (MRI). Glycerol, which is widely used as an osmotic agent against cerebral edema, could exacerbate brain tissue shift, since it has been suggested that glycerol might shrink a noninfarcted hemisphere and worsen the mass effect after a large hemispheric cerebral infarction. To investigate these issues, changes in a large hemispheric infarction with cerebral edema were studied using MRI before and after glycerol administration. Infarct volumes, normal brain tissue volumes and lateral ventricle volumes, in addition to signal intensities of T(2)-weighted images, were measured in six patients before and after administration of 300 ml of glycerol. Ventricle volumes were significantly increased (p=0.0015) and the T(2) signal intensity of the post-treatment ischemic region decreased after glycerol administration. In contrast, no significant differences in either cerebral volume or T(2) signal intensity were seen in the noninfarcted hemisphere before and after administration. Our data suggest that glycerol does not exacerbate the mass effect on a large hemispheric infarction.
authors.affiliation: Second Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8602, Tokyo, Japan. sakamaki@m7.dion.ne.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Sakamaki
authors.forename: Hironaka
authors.initials: H
authors.lastname: Igarashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hagiwara
authors.forename: Jun
authors.initials: J
authors.lastname: Ando
authors.forename: Tetsurou
authors.initials: T
authors.lastname: Chishiki
authors.forename: Brian C
authors.initials: BC
authors.lastname: Curran
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000368:Aged; D001921:Brain / Q000187:drug effects; D001929:Brain Edema / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D002552:Cerebral Ventricles / Q000187:drug effects; D004338:Drug Combinations; D005632:Fructose / Q000627:therapeutic use*; D005990:Glycerol / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D009994:Osmolar Concentration; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D005632:Fructose; D005990:Glycerol