 |
|
Hyperglycemia, Polyol Accumulation, and Increased Intracranial Pressure
Leon D. Prockop, MD
Arch Neurol. 1971;25(2):126-140.
Abstract
Increased intracranial pressure reproducibly occurs in hyperglycemic dogs when the blood glucose level is permitted to fall precipitously and they are rehydrated with isotonic saline solutions. Water intoxication, carbon dioxide accumulation, and osmotic and electrolyte differences between the cerebrospinal fluid (CSF) and plasma did not play major roles in the production of the observed increases in CSF pressure. There was a significant rise in CSF and brain concentrations of fructose and sorbitol in response to hyperglycemia, suggesting that the level of blood glucose regulates the rate of sorbitol and fructose synthesis within the central nervous system, and that there was an increased activity of the polyol (glucose/sorbitol/ fructose) pathway. This potential for the production of increased intracranial pressure may be responsible for the fatal acute cerebral edema observed during the treatment of diabetic acidosis.
Author Affiliations
Philadelphia
From the Department of Neurology, Hospital of the University of Pennsylvania and the Penn Neurology Service, Philadelphia General Hospital, Philadelphia.
Footnotes
Accepted for publication Jan 13, 1971.
Reprint requests to Philadelphia General Hospital, Philadelphia 19104 (Dr. Prockop).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Cerebral Edema in Diabetic Ketoacidosis: A Look Beyond Rehydration
Muir
J. Clin. Endocrinol. Metab. 2000;85:509-513.
FULL TEXT
Relation of Colloid Osmotic Pressure to Arterial Hypoxemia and Cerebral Edema During Crystalloid Volume Loading of Patients with Diabetic Ketoacidosis
FEIN et al.
ANN INTERN MED 1982;96:570-575.
ABSTRACT
Diabetic Ketoacidosis: New Concepts and Trends in Pathogenesis and Treatment
KREISBERG
ANN INTERN MED 1978;88:681-695.
ABSTRACT
|
