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November 1969

Electrolytes, Fluids, and Energy Metabolism in Human Cerebral Edema

Arch Neurol. 1969;21(5):517-525. doi:10.1001/archneur.1969.00480170089009

DURING the last years, two forms of cerebral edema have been differentiated by electronmicroscopic and biochemical studies in animals: an intracellular form, affecting mainly the cortex and the gray matter and an extracellular form appearing predominantly in the white matter. Recent electron-optic studies suggest the existence of a similar difference of edema in man.1-4 The present investigation was undertaken to study the distribution of pathological fluid accumulation in the gray and white matter and to analyze some of the chemical constituents of the edema fluid. The question of whether the oxygen supply in edematous regions is sufficient also raises special interest. Since at present there is no method available for the determination of oxygen consumption in individual brain areas, we have performed an analysis of the energy-rich phosphates and of glycolysis of the edematous brain tissue, since these metabolites show typical changes immediately with the onset