Mannitol bolus preferentially shrinks non-infarcted brain in patients withischemic stroke

Changes in brain tissue volume in six patients who had acute complete middl e cerebral artery (MCA) infarctions and CT evidence of midline shift were m easured using the brain boundary shift integral (BBSI) on sequential Tl-wei ghted MR images acquired before and after a 1.5-g/kg bolus infusion of mann itol. At 50 to 55 minutes after the baseline scan, total brain volume decre ased by 8.1 +/- 2.8 mL (0.6%, p < 0.005). Brain in the noninfarcted hemisph ere shrank more (0.8 +/- 0.4%) than in the infarcted hemisphere (0.0 +/- 0. 5%, p < 0.05).