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The effect of large doses of dexamethasone on the cerebrospinal fluid pressure in patients with supratentorial tumors

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Summary

The effect of large doses of dexamethasone (80 mg) on the cerebrospinal fluid pressure (CSFP) was investigated with continuous lumbar CSFP measurement over 24h in 10 patients with supratentorial cerebral tumors and clinical signs of elevated intracranial pressure. There was a further slight rise in CSFP with an unchanged pressure pattern in the course of observation of the untreated control group. A marked lowering of CSFP was observed within 6h after initial intravenous administration of dexamethasone to seven of the treated patients. In four of the treated patients an unequivocal and in five only a moderate CSFP lowering was measured at the end of the registration. One patient had a slight rise in pressure. The plateau waves of all the patients treated decreased in height, frequency and duration within the first hours, while fluctuations in pressure level and CSFP amplitude were reduced.

Zusammenfassung

Mit der kontinuierlichen lumbalen Liquordruckmessung wurde bei 10 Patienten mit supratentoriellen Hirntumoren und klinischen Zeichen intrakranieller Drucksteigerung über 24 Std die Wirkung hoher Dosen Dexamethason (80 mg) auf den Liquordruck (CSFP) untersucht. Während es bei der Kontrollgruppe (unbehandelte Patienten) im Laufe der Registrierung zu einem weiteren leichten CSFP-Anstieg bei unverändertem Druckmuster kam, wurde bei 7 der behandelten Patienten innerhalb 6 Std nach initialer intravenöser Dexamethasongabe eine deutliche CSFP-Senkung beobachtet. Bei 4 der behandelten Patienten wurde zum Ende der Registrierung eine eindeutige, bei 5 eine nur mäßige CSFP-Senkung gemessen. 1 Patient wies einen leichten Druckanstieg auf. Bei allen behandelten Patienten nahmen die Plateauwellen innerhalb der ersten Stunden an Höhe, Häufigkeit und Dauer ab, Druckniveauschwankungen und Liquordruckamplituden verringerten sich.

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Authors and Affiliations

  1. Neurological Clinic of the University of Heidelberg, Voßstraße 2, D-6900, Heidelberg, Federal Republic of Germany

    E. Alberti, A. Hartmann, H. -J. Schütz & F. Schreckenberger

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  1. E. Alberti
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  2. A. Hartmann
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  3. H. -J. Schütz
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  4. F. Schreckenberger
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Alberti, E., Hartmann, A., Schütz, H.J. et al. The effect of large doses of dexamethasone on the cerebrospinal fluid pressure in patients with supratentorial tumors. J. Neurol. 217, 173–181 (1978). https://doi.org/10.1007/BF00312958

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  • DOI: https://doi.org/10.1007/BF00312958

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