Related Experiment Video
Updated: Jul 14, 2026
10:19
Induction of an Isoelectric Brain State to Investigate the Impact of Endogenous Synaptic Activity on Neuronal Excitability In Vivo
Published on: March 31, 2016
Electrolyte changes during craniotomy caused by administration of hypertonic mannitol.
Zaki-Udin Hassan1, Justin J Kruer, Thomas M Fuhrman
1Department of Anesthesiology, University of Kentucky School of Medicine, Lexington, KY, USA.
Journal of Clinical Anesthesia
|June 19, 2007
Summary
A patient developed peaked T waves, hyperkalemia, and hyponatremia after receiving mannitol for a recurrent astrocytoma surgery. This highlights potential electrolyte imbalances and cardiac changes associated with mannitol administration in neurosurgery.
Area of Science:
- Neurosurgery
- Oncology
- Critical Care Medicine
Background:
- A 31-year-old woman underwent a right frontal craniotomy for a recurrent grade 3 astrocytoma.
- Mannitol, an osmotic diuretic, was administered preoperatively at the surgical team's request.
Observation:
- Electrocardiography revealed characteristic peaked T waves.
- Laboratory tests indicated significant electrolyte disturbances.
Findings:
- The patient presented with hyperkalemia (elevated serum potassium).
- Hyponatremia (low serum sodium) was also detected.
- These findings correlated with the administration of mannitol.
Implications:
- Mannitol can induce potentially life-threatening electrolyte imbalances, including hyperkalemia and hyponatremia.
- Continuous electrocardiographic monitoring and electrolyte assessment are crucial during and after mannitol administration in neurosurgical patients.
- This case underscores the importance of vigilant patient monitoring for adverse effects of commonly used perioperative medications.
More Related Videos
Related Concept Videos
01:21Cytotoxic Edema: Pathophysiology
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...
01:19Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:16Tonicity in Animals
Tonicity describes the amount of solute in a solution. The measure of the tonicity of a solution, or the total amount of solutes dissolved in a specific amount of solution, is called its osmolarity. Three terms—hypotonic, isotonic, and hypertonic—are used to relate the osmolarity of a cell to the osmolarity of the extracellular fluid that contains the cells. In a hypotonic solution, such as tap water, the extracellular fluid has a lower concentration of solutes than the fluid inside the cell,...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...