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RELATIVE VALUES OF CAFFEINE AND HYPERTONIC DEXTROSE AND SALINE SOLUTIONS IN REDUCING CEREBROSPINAL FLUID PRESSURE

ABRAM BLAU, M.D.
Arch Intern Med (Chic). 1936;57(4):749-757. doi:10.1001/archinte.1936.00170080103007.
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The intravenous injection of a hypertonic solution of dextrose for the purpose of reducing the cerebrospinal fluid pressure is a common procedure in the treatment of neurologic disturbances, although few direct observations of its effects have been reported in the literature. The procedure is based mainly on a number of experimental studies on animals.1 During exploratory craniotomy, Fay2 observed a decrease in the dural tension following the intravenous administration of a 15 per cent saline solution. A number of observers have measured the effect of these solutions by the application of a tambour next to postoperative cranial defects or herniations, but their results are contradictory. Ebaugh and Stevenson3 noted a prolonged fall in pressure after the intravenous administration of 200 cc. of a 30 per cent dextrose solution, while Stevenson and his associates4 noted only a slight effect. Foley5 used a 15 per cent saline solution

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