title: Hypertonic saline in elevated intracranial pressure: past, present, and future.
abstract: Hypertonic Saline (HS) has been a proven and effective therapy and a safe alternative to mannitol in patients with increase intracranial pressure (ICP). We hereby present a case of 25-year-old women with intracranial bleed secondary to right parietal arteriovenous malformation. Patient underwent surgery for evacuation of hematoma and resection of arteriovenous malformation. Post- operative course was complicated by recurrent episodes of elevated ICP. She received total of 17 doses of 23.4% HS and 30 doses of mannitol with good outcome. Despite reluctance from some clinicians to use HS, hypertonic saline seems to be a safe and effective therapy.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Texas A&M University, TX, USA srsurani@hotmail.com.
authors.forename: Salim
authors.initials: S
authors.lastname: Surani
authors.affiliation: Christus Spohn Hospital, Corpus Christi, TX, USA.
authors.forename: Geoff
authors.initials: G
authors.lastname: Lockwood
authors.affiliation: Christus Spohn Hospital, Corpus Christi, TX, USA.
authors.forename: Melissa Y
authors.initials: MY
authors.lastname: Macias
authors.affiliation: Corpus Christi, TX, USA.
authors.forename: Bharat
authors.initials: B
authors.lastname: Guntupalli
authors.affiliation: The University of Texas Health Science Center at Houston, TX, USA The University of Texas Medical Branch at Galveston, TX, USA University General Hospital, Houston, TX, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Varon
mesh_terms: D056424:Decompressive Craniectomy; D004234:Diuretics, Osmotic / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008353:Mannitol / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D064926:Neurophysiological Monitoring; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D004234:Diuretics, Osmotic; D012462:Saline Solution, Hypertonic; D008353:Mannitol
keywords: cerebral edema; hypertonic saline; intracranial hypertension; intracranial pressure; mannitol; stroke