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December 10, 1982

Hypervolemic Hemodilution in Acute Stroke

Author Affiliations

Naval Medical Research Institute Bethesda, Md

JAMA. 1982;248(22):3014. doi:10.1001/jama.1982.03330220058040

The article by Wood and Fleischer (p 2999) reports an excellent therapeutic response to hypervolemic hemodilution in nine consecutive unselected patients with acute stroke, the third leading cause of death in the United States. Eight of nine patients showed objective improvement of their acute neurological deficits, and one patient with a depressed level of consciousness, a grave prognosticator,1 died. Published accounts of the natural history of acute hemispheric cerebral ischemia2 would lead to the expectation that of nine consecutive patients, three or four would improve, three to five would remain unchanged or deteriorate, and one to three would die. The observed results of Wood and Fleischer contrast favorably with these expectations and suggest a potential therapeutic value for hypervolemic hemodilution in acute stroke.

The results also provide an encouraging follow-up to experimental work in animals done by one of the authors. This prospective evaluation, however, is not a