Effect of Hypertonic Solutions on Cerebrospinal Fluid Pressure with Special Reference to Secondary Rise and Toxicity.

Abstract

The effect of hypertonic solution on the spinal fluid pressure is of vital importance from a clinical standpoint, since Weed and McKibben1 show that the cerebrospinal fluid volume could be reduced by intravenous injection of hypertonic solution. Cushing and Foley2 and Foley and Putnam3 applied this observation to clinical cases of increased intracranial pressure and it was immediately recognized of importance in the treating of head injuries. However, Browder4 among others pointed out from clinical observations: first, the toxicity of NaCl solution, and second, the occasional deaths that occur after a short period of clinical improvement after intravenous administration of hypertonic solution in cases of head injuries with symptoms of increased intracranial pressure.Our experiments were carried out on a series of 10 dogs and one man. We used various concentrations of NaCl and of glucose. The results were uniform. First, it was demonstrated that hypertonic saline has a definitely toxic effect, which in con...