Clinical neurosurgery
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Hyperventilation, ventricular drainage, and mannitol remain the mainstays of the treatment of cerebral edema not amenable to or following surgical therapy. There appears to be good therapeutic rationale for the use of "low-dose" mannitol in more prolonged treatment of intracranial hypertension (Table 5.1). ⋯ Certainly, the "ideal" agent for the treatment of cerebral edema, one that would selectively mobilize and/or prevent the formation of edema fluid with a rapid onset and prolonged duration of action, and with minimal side effects, remains to be discovered. In the meantime, research to refine the use of the older agents and determine the usefulness of the newer ones should be encouraged.