Advertisement

Use of Dexamethasone and Frusemide in Brain Edema Resulting from Brain Tumors

  • G. Meinig
  • H. J. Reulen
  • S. Wende
  • K. Schürmann

Abstract

Referring to our previous papers [34, 35, 36, 40] concerning the treatment of peritumoral brain edema (BE) we have presented three possibilities for the assessment of antiedema treatment in brain tumor patients. By the use of these methods:
  1. 1.

    determination of water and electrolyte content in the peritumoral edema,

     
  2. 2.

    CT follow-up studies,

     
  3. 3.

    progress of neurological condition,

     
it is possible to estimate the quantitative effectiveness of different forms of antiedema treatment separately and in combination. This is important for the patient suffering from brain tumor since the antiedema treatment has to be adapted to the individual situation according to the presence or absence of symptoms of increased intracranial pressure (ICP), symptoms of impending herniation, as well as to the degree of peritumoral BE, the nature of the tumor, timing of craniotomy/biopsy (often determined by extrinsic factors) etc. In this study we have tested only two substances which are very important in antiedema therapy (apart from intensive care) namely, dexamethasone (D) and frusemide (F) as well as their combination (D/F).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Adachi M, Feigin I (1966) Cerebral oedema and the water content of normal white matter. J Neurol Neurosurg Psychiat 29: 446–450PubMedCrossRefGoogle Scholar
  2. 2.
    Baethmann A, Lanksch W, Schmiedek P (1974) Formation and treatment of cerebral edema. Neurochirurgia 17, 37–47PubMedGoogle Scholar
  3. 3.
    Baethmann A, Oettinger W, Rothenfusser R (1977) Chemical mediator compounds in brain edema. Eur Surg Res 9:( Suppl. I), 121–122Google Scholar
  4. 4.
    Brock M, Wiegand H, Zillig C, Zywietz C, Mock P, Dietz H (1976) The effect of dexamethasone on intracranial pressure in patients with supra tentorial tumors. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 330–336Google Scholar
  5. 5.
    Clasen RA, Huchman MS, Pandolfi S, Laing I, Jacobs J (1976) Computed tomography of vasogenic cerebral edema. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 278–282Google Scholar
  6. 6.
    Clasen RA, Huckmann MS, von Roenn KA, Pandolfi S, Laing I, Clasen JR (1980) Time course of cerebral swelling in stroke: A correlative autopsy and CT study. Advances in Neurology 28: 395–412PubMedGoogle Scholar
  7. 7.
    Cserr HF, Cooper DN, Milhorat TH (1976) Production, circulation and absorption of brain interstitial fluid. In: Dynamics of brain edema. Pappius HM, Feindel W (eds )Google Scholar
  8. 8.
    Faupel G, Reulen HJ, Müller D, Schürmann K (1976) Double-blind study on the effects of steroids on severe closed head injury. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 337 - 343Google Scholar
  9. 9.
    Faupel G, Reulen HJ, Müller D, Schürmann K (1978) Dexamethason bei schweren Schädel-Hirn-Traumen. Akt traumatol 8: 265 – 281Google Scholar
  10. 10.
    Fenske A, Fischer M, Regli F, Hase U (1979) The response of focal ischemic cerebral edema to Dexamethasone. J Neurol 220: 199–209PubMedCrossRefGoogle Scholar
  11. 11.
    Frei HJ, Poll W, Reulen HJ, Brock M, Schürmann K (1971) Regional energy metabolism, tissue lactate content and rCBF in cold injury edema. In: Brain and blood flow. Ross Rüssel RW (ed). Pitman Medical and Scientific Publishing Co, London, pp 125–129Google Scholar
  12. 12.
    Frei HJ, Wallenfang Th, Poll W, Schubert R, Brock M (1973) Regional cerebral blood flow and regional metabolism in cold induced brain edema. Acta Neurochirurg 29: 15–28CrossRefGoogle Scholar
  13. 13.
    Gaab M, Knoblich OE, Schupp J, Dietrich K, Fuhrmeister U, Gruss P (1978) Wirkung unterschiedlicher Osmo- und Onkotherapie auf Hirndruck und elektrische Hirnaktivität beim experimentellen Hirnödem. Acta Neurochir 40: 203–221CrossRefGoogle Scholar
  14. 14.
    Galicich JH, French LA (1961) Use of dexamethasone in the treatment of cerebral edema resulting from brain tumors and brain surgery. Am Practitioner 12: 169–174PubMedGoogle Scholar
  15. 15.
    Geigy wissenschaftliche Tabellen. 7. Auflage, p 515, 1968Google Scholar
  16. 16.
    Hadjidimos A, Brock M, Haas JP, Dietz H, Wolf R, Ellger M, Fischer F, Schürmann K (1969) Correlation between rCBF, angiography, EEG and Scanning in brain tumors. In: Cerebral blood flow. Springer, Berlin Heidelberg New York, pp 190–193Google Scholar
  17. 17.
    Hadjidimos A, Steingass U, Fischer F, Reulen HJ, Schürmann K (1973) The effect of dexamethasone on rCBF and cerebral vasomotor response in brain tumor. Eur Neurol 10: 25–30PubMedCrossRefGoogle Scholar
  18. 18.
    Hartmann A, Schütz HJ, Alberti E, Schreckenberger F, Loew F, Pycka J (1977) Effects of a new diuretic on Cerebrospinal Fluid Pressure in patients with supratentorial tumors. Arch Psychiat Nervenkr 224: 351–360PubMedCrossRefGoogle Scholar
  19. 19.
    Hartmann A, Alberti E (1977) Eine einfache Methode zur kontinuierlichen Messung des Liquordrucks. Acta Neurochir 36: 201–214CrossRefGoogle Scholar
  20. 20.
    Hartmann A, Alberti E (1977) Differentiation of communicating hydrocephalus and presenile dementia by continuous recording of cerebrospinal fluid pressure. J Neurol Neurosurg Psychiat 40: 630–640PubMedCrossRefGoogle Scholar
  21. 21.
    Hase U (1978) Intrakranielle Drucksteigerung. Neurochirurgia 21: 145–157PubMedGoogle Scholar
  22. 22.
    Hase U, Reulen HJ, Meinig G, Schürmann K The influence of the decompressive operation on the intracranial pressure and the pressure-volume relation in patients with severe head injuries. Acta Neurochir (in press)Google Scholar
  23. 23.
    Klatzo I, Wisniewski H, Steinwall O, Streicher E (1967) Dynamics of cold injury edema. In: Brain edema. Klatzo I, Seitelberger F (eds). Springer, Wien New York, pp 554–563Google Scholar
  24. 24.
    Lanksch W, Oettinger W, Baethmann A, Kazner E (1976) CT findings in brain edema compared with direct chemical analysis of tissue samples. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 283–287Google Scholar
  25. 25.
    Lanksch W, Kazner E (1976) CT findings in brain edema. In: Cranial Computerized Tomography. Lanksch W, Kazner E (eds). Springer, Berlin Heidelberg New York, pp 344–355Google Scholar
  26. 26.
    Long DM, Hartmann JF, French LA (1966) The response of human cerebral edema to glucosteroid administration. Neurology 16: 521–528PubMedGoogle Scholar
  27. 27.
    Long DM, Maxwell RE, French LA (1971) The effects of glucosteroids upon cold induced brain edema. J Neuropathol Exp Neurol 30: 680–697PubMedCrossRefGoogle Scholar
  28. 28.
    Long DM, Maxwell RE, Choi KS, Cole HO, French LA (1972) Multiple therapeutic ap-proaches in the treatment of brain edema induced by a standard cold lesion. In: Steroids and brain edema. Reulen HJ, Schürmann K (eds). Springer, Berlin Heidelberg New York, pp 87–94Google Scholar
  29. 29.
    Long DM, Maxwell RE, Choi KS (1976) A new therapy regimen for brain edema. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 293–300Google Scholar
  30. 30.
    Marshall LF, Bruce DA, Graham DI (1976) Alterations in behavior, brain electrical activity, cerebral blood flow, and intracranial pressure produced by triethyl tin sulfate induced cerebral edema. Stroke 7: 21–25PubMedCrossRefGoogle Scholar
  31. 31.
    Marshall LF (1980) Treatment of brain swelling and brain edema in man. Advances in Neurology 28: 459–469PubMedGoogle Scholar
  32. 32.
    Maxwell RE, Long DM, French LA (1971) The effects of glucosteroids upon cold-induced brain edema. In: Gross morphological vascular permeability changes. J Neurosurg 34: 477–487Google Scholar
  33. 33.
    Maxwell RE, Long DM, French LA (1972) The clinical effects of a synthetic glucocorticoid used for brain edema in the practice of neurosurgery. In: Steroids and brain edema. Reulen HJ, Schürmann K (eds). Springer, Berlin Heidelberg New York, pp 219–232Google Scholar
  34. 34.
    Meinig G, Aulich A, Wende S, Reulen HJ (1976) Resolution of peritumoral brain edema following combination therapy with dexamethasone and furosemide. Adv Neurosurg 4: 207–211Google Scholar
  35. 35.
    Meinig G, Aulich A, Wende S, Reulen HJ (1976) The effect of dexamethasone and diuretics on peri tumor brain edema: Comparative study of tissue water content and CT. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 301–305Google Scholar
  36. 36.
    Meinig G, Reulen HJ, Simon RS, Schürmann K (1980) Clinical, chemical and CT evaluation of short-term and long-term antiedema therapy with dexamethasone and diuretics. Advances in Neurology 28: 471–489PubMedGoogle Scholar
  37. 37.
    Miller JD, Gudeman SK, Kishore PS, Becker DP (1980) Computed tomography in brain edema due to trauma. Advances in Neurology 28: 413–422PubMedGoogle Scholar
  38. 38.
    Pappius HM (1972) Effects of steroids on cold injury edema. In: Steroids and brain edema. Reulen HJ, Schürmann K (eds). Springer, Berlin Heidelberg New York, pp 57–63Google Scholar
  39. 39.
    Penn RD (1980) Cerebral edema and neurological function: CT, evoked responses, and clinical examination. Advances in Neurology 28: 383–394PubMedGoogle Scholar
  40. 40.
    Reulen HJ, Hadjidimos A, Schürmann K (1972) The effect of dexamethasone on water and electrolyte content and on rCBF in perifocal brain edema in man. In: Steroids and brain edema. Reulen HJ, Schürmann K (eds). Springer, Berlin Heidelberg New York, pp 239–252Google Scholar
  41. 41.
    Reulen HJ, Graham R, Fenske A, Tsuyumu M, Klatzo I (1976) The role of tissue pressure and bulk flow in the formation and resolution of cold-induced edema. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 103–112Google Scholar
  42. 42.
    Reulen HJ, Graham R, Spatz M, Klatzo I (1977) Role of pressure gradients and bulk flow in dynamics of vasogenic brain edema. J Neurosurg 46: 24–35PubMedCrossRefGoogle Scholar
  43. 43.
    Schmiedek P, Guggemos L, Baethmann A, Lanksch W, Kazner E, Picha B, Oltenau-Nerbe V, Enzenbach R, Brendel W, Marguth F (1976) Re-evaluation of short-term steroid therapy for perifocal brain edema. In: Dynamics of brain edema. Pappius HM, Feindel W (eds). Springer, Berlin Heidelberg New York, pp 344–350Google Scholar
  44. 44.
    Thilmann J, Zeumer H (1974) Untersuchungen zur Behandlung des Hirnödems mit hohen Dosen Furosemid. Dtsch Med Wschr 99: 932–935CrossRefGoogle Scholar
  45. 45.
    Yates AJ, Thelmo W, Pappius HM (1975) Post-mortem changes in the chemistry and histology of normal and edematous brains. Am J Pathol 79: 555–564PubMedGoogle Scholar
  46. 46.
    Begleitblatt und Verlaufskontrolle fur Schädel-Hirnverletzte (6. Aufl.) (Faupel et al.)Google Scholar
  47. 47.
    Verlaufskontrollblatt fur die Neurochirurgische Intensivstation, deployed by Arbeitsgruppe “Schädel-Hirntrauma” der Deutschen Gesellschaft fur NeurochirurgieGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1982

Authors and Affiliations

  • G. Meinig
  • H. J. Reulen
  • S. Wende
  • K. Schürmann

There are no affiliations available

Personalised recommendations