[Is the increase in brain volume of abstinent alcoholics a sequela of rehydration?]

A group of 30 alcoholics as identified using the MALT score were examined both within the first 36 h of alcohol withdrawal and then again at the end of a 10-day treatment in hospital. We looked for clinical signs of dehydration, water and electrolyte imbalance, and concentration of steroid metabolites in the urine. Cranial computed tomography was also performed twice, again at the beginning and end of the 10-day period. The size of cerebrospinal fluid spaces was calculated through measuring the frontal interhemisphere distance, the width of cortical sulci, the ventricle III diameter, the Cella media index and also the number of vermal sulci. All patients had a brain atrophy which did not disappear within the 10 days. The neuroradiological parameters remained completely unchanged in the control examination. However, the laboratory parameters of the internal milieu had normalized. Therefore, it is submitted that the shrinkage of the brain of alcoholics cannot be due to a reversible intra- or extracellulary dehydration. There was also no proof of a hormonal cause for the brain shrinkage. As a consequence other etiological factors gain importance, such as malnutrition or a toxic alcohol effect.