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Vol 8, No 1 (2006)
Prace oryginalne
Published online: 2006-01-23
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Mannitol treatment monitoring in stroke patients with intracranial hypertension syndrome

Magdalena Nowaczewska, Barbara Książkiewicz
Udar Mózgu. Problemy Interdyscyplinarne 2006;8(1):1-9.

open access

Vol 8, No 1 (2006)
Prace oryginalne
Published online: 2006-01-23

Abstract

Introduction. Intracranial hypertension is a life threaten complication of stroke. The most popular treatment is osmotherapy using 20% mannitol. The therapy monitoring was possible only using invasive tools. Transcranial doppler examination (TCD) allows noninvasive monitoring of intracranial hypertension treatment by measurement of blood flow velocity (BFV) and pulsatility index (PI) in media cerebral arteries (MCA). The aim of this study was to assess the clinical usefulness and prognostic value of TCD in monitoring mannitol therapy.
Material and methods. 30 patients with intracranial hypertension as a complication of supratentorial stroke were treated with 20% mannitol, 3 or 4 times per day, i.v., 18 patients with ischemic stroke and 12 patients with haemorrhagic stroke. Before the mannitol drip neurological examination with the assessment in GSC and ITC scales were performed. This procedure was repeated 60 minutes after mannitol drip. After neurological examination, before and 30 and 60 min after mannitol drip TCD was performed including measurements of BFV and PI in both MCA.
Results. BFV increased and PI decreased 30 minutes after mannitol drip; changes were greater in the group of patients who survived comparing with the group who died. The greatest changes were observed during the first mannitol drips. There was a statistically significant correlation between BFV, PI and GCS, ITC scoring and a correlation between BFV and PI in both MCA before and 30 and 60 minutes after mannitol drip.
Conclusion. Transcranial doppler examination allows noninvasive assessment of mannitol therapy and can be used in patient with intracranial hypertension due to stroke. Changes of BFV and PI after mannitol drip may be used as a prognostic sign in patients with stroke.

Abstract

Introduction. Intracranial hypertension is a life threaten complication of stroke. The most popular treatment is osmotherapy using 20% mannitol. The therapy monitoring was possible only using invasive tools. Transcranial doppler examination (TCD) allows noninvasive monitoring of intracranial hypertension treatment by measurement of blood flow velocity (BFV) and pulsatility index (PI) in media cerebral arteries (MCA). The aim of this study was to assess the clinical usefulness and prognostic value of TCD in monitoring mannitol therapy.
Material and methods. 30 patients with intracranial hypertension as a complication of supratentorial stroke were treated with 20% mannitol, 3 or 4 times per day, i.v., 18 patients with ischemic stroke and 12 patients with haemorrhagic stroke. Before the mannitol drip neurological examination with the assessment in GSC and ITC scales were performed. This procedure was repeated 60 minutes after mannitol drip. After neurological examination, before and 30 and 60 min after mannitol drip TCD was performed including measurements of BFV and PI in both MCA.
Results. BFV increased and PI decreased 30 minutes after mannitol drip; changes were greater in the group of patients who survived comparing with the group who died. The greatest changes were observed during the first mannitol drips. There was a statistically significant correlation between BFV, PI and GCS, ITC scoring and a correlation between BFV and PI in both MCA before and 30 and 60 minutes after mannitol drip.
Conclusion. Transcranial doppler examination allows noninvasive assessment of mannitol therapy and can be used in patient with intracranial hypertension due to stroke. Changes of BFV and PI after mannitol drip may be used as a prognostic sign in patients with stroke.
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Keywords

stroke; osmotherapy; transcranial doppler examination

About this article
Title

Mannitol treatment monitoring in stroke patients with intracranial hypertension syndrome

Journal

Interdisciplinary Problems of Stroke

Issue

Vol 8, No 1 (2006)

Pages

1-9

Published online

2006-01-23

Bibliographic record

Udar Mózgu. Problemy Interdyscyplinarne 2006;8(1):1-9.

Keywords

stroke
osmotherapy
transcranial doppler examination

Authors

Magdalena Nowaczewska
Barbara Książkiewicz

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