Determination of cerebral water content by magnetic resonance imaging after small volume infusion of 18% hypertonic saline solution in a patient with refractory intracranial hypertension

Eur J Emerg Med. 2002 Sep;9(3):262-5. doi: 10.1097/00063110-200209000-00011.


Hypertonic saline solution (HSS) has been investigated in the treatment of intracranial hypertension (ICH) in a limited number of studies, usually after failure of conventional treatment. HSS, used in concentrations that vary from 3% to 23.4%, seems to be effective in reducing refractory ICH and to be devoid of adverse effects. We treated a patient with refractory ICH with a small-volume infusion of 18% HSS, and performed magnetic resonance imaging (MRI) before and after HSS infusion. MRI showed a marked reduction in cerebral water content 1 h after the infusion. To our knowledge, this is the first MRI study in a patient with brain injury to evaluate the effect of HSS on brain water content. Further studies are necessary to test HSS efficacy and to identify, through MRI or computed tomography (CT) scan imaging, a subgroup of patients with brain injury who would be best treated with HSS.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Brain Edema / drug therapy*
  • Brain Injuries / therapy*
  • Hemodynamics
  • Humans
  • Intracranial Hypertension / drug therapy*
  • Intracranial Hypertension / etiology
  • Intracranial Pressure* / drug effects
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Saline Solution, Hypertonic / therapeutic use*
  • Treatment Outcome


  • Saline Solution, Hypertonic