J.Jpn. Surg. Soc.. 58(7): 1053-1076, 1957
THE CHANGES OF SERUM ELECTROLYTES AND PROTEINS IN NEUROSURGICAL CASES
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Department of Surgery, Faculty of Medicine, Tohoku University,, Sendai (Director: Prof. S-T. Katsura) Chen Wu Chowu |
1. In neurosurgical cases, haematocrit and the concentration of serum protein do not show the degree of dehydration as far as dehydration is not severe.
2. Serum proteins and its fraction(%)after operations on the brain do not show any characteristic changes.
3. Contrary to the tendency of low sodium concentration in the blood observed postoperatively in patients who underwent general surgical procedures, many neurosurgical cases show hypernatremia. Water deficiency and injection of 50% glucose solution are not playing the major role for this phenomenon.
4. When operation is performed either on the frontal lobe, or brain stem, hypernatremia, hyperchloremia and hyperkalemia are liable to be observed postoperatively. The same phenomenon applies in case lesion exists only in that area.
5. In most cases with intracranial pressure over 300 mmH2O, hyper-natremia, -chloremia and-kalemia are observed.
6. The prognosis of neurosurgical cases showing high values of serum electolytes is poor.
7. In neurosurglcal cases, there may be abnormal electrolyte metabolism which will be induced by disturbance to the neural metabolic centre. Its controlling centre seems to be located in the brain stem.
8. Intravenous injection of 5% glucose solution by drip method has stronger effect to elevate the intracranial pressure than injectian of 0.9% saline solution.
9. In neurosurgical cases, abnormal serum electrolytes, especially high value of electrolytes in serum are observed. Due attention should be paid to this phenomenon.
(author's abstract)
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