Abstract

EVALUATION OF ROLE OF MANNITOL IN THE ASSESSMENT OF CHANGE OF INTRACRANIAL HAEMATOMA VOLUME BY NEUROIMAGING CT IN ACUTE INTRACEREBRAL HAEMORRHAGE

Author(s): Mrinalkanti Ghosh1, Chiranjib Nag2

BACKGROUND
Mannitol has been used for several years to reduce cerebral oedema in acute ICH (intracerebral haemorrhage). Study on mannitol with its effect on haematoma volume and clinical outcome is limited.
The main aim of this study is to measure haematoma volume before and after mannitol therapy in acute spontaneous ICH.
MATERIALS AND METHODS
Total 60 patients were analysed after inclusion and exclusion criteria. On admission, non-contrast CT scan was done on day 1 and day 7. Infusion mannitol 20% of 100 mL every 6 hourly was infused. Clinical outcome was measured by National Institute of Health Stroke Scale (NIHSS). Haematoma volume was measured on day 1 and day 7 of hospital admission. Statistical analysis was done using SPSS software.
Settings and Design- A prospective observational study done in admitted patients presented in first day of onset of acute stroke.
RESULTS
The change of haematoma volume from day 1 value 21.7 cm3 (±11.2) to day 7 value 15.4 cm3 (±8.3) is significant (p value=0.008). Decreased NIHSS score from baseline value of 17.1 (±7.6) to 12.1 (±7.1) on day 7 is significant (p value=0.3). NIHSS score on day 7 was highly influenced by haematoma volume on day 1 (p value=0.001) and haematoma volume on day 7 (p value=0.01).
CONCLUSION
Mannitol therapy in first few days of hospital stay is effective in reducing haematoma volume and in improving clinical outcome.
KEYWORDS
Mannitol, Haematoma Volume, CT Scan, ICH.