• Tareq Kheirbek and Jose L Pascual.
• Division of Traumatology, Surgical Critical Care & Emergency Surgery, University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, PA, USA, Tareq.Kheirbek@uphs.upenn.edu.
• Curr Neurol Neurosci Rep. 2014 Sep 1;14(9):482.

AbstractIntracranial hypertension is caused by brain edema generated by different disorders, the commonest of which is traumatic brain injury. The treatment of brain edema focuses on drawing water out of brain tissue into the intravascular space. This is typically accomplished with osmolar therapy, most commonly mannitol and hypertonic saline. Recent human trials suggest that hypertonic saline may have a more profound and long-lasting effect in reducing intracranial hypertension following traumatic brain injury when compared with mannitol. However, reports suffer from inconsistencies in dose, frequency, concentration, and route of administration. Side effect profile, potential complications, and contraindications to administration need to be factored in when considering which first-line osmotherapy to choose for a given patient with head injury.

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