J.Jpn. Surg. Soc.. 62(9): 951-977, 1961

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TREATMENT OF ELEVATED INTRACRANIAL PRESSURE WITH HYPERTONIC UREA SOLUTION

The author investigated the effect of the intravenous administration of a hypertonic urea solution on the elevated intracranial pressure in 78 patients and confirmed a remarkable reduction of the intracranial pressure. The results are summarized as follows :
1. The intravenous infusion of 30% urea solution was more effective in pressure reduction than 50% glucose and PVP. solution.
2. A combined solution of urea with PVP. ATP and Vitamin B₁ was more effective than urea alone for the reduction of the cerebrospinal fluid pressure.
3. Urea also reduced the intraocular pressure.
4. Blood pressure, hematocrit value, serum protein concentration, plasma electrophoresis and electrolyte values in serum and cerebrospinal fluid were not altered after the urea infusion.
5. Urea level in the cerebrospinal fluid exceeded that in the blood temporarily in its course. All the administered was excreted through the kidney in 24 hours.
6. Electroencephalographic findings and hemodynamics of the cerebral circulation improved clinically.
7. The dehydration not only of the brain but also other parenchymatous organs was noticed in animal experiments.
8. No untoward side effect was observed.
9. Signs of the elevated intracranial pressure; headache, nausea, vomiting, etc. improved appreciably with the use of usea. Remarkable shrinkage of the brain tissue at the time of craniotomy was also observed.
10. From the above findings, it might be concluded that the intravenous administration of the hypertonic urea solution is a valuable method of treatment for the edema and swelling of the brain.
(Author's abstract)

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