[Immediate effects of intravenous acetazolamide on intracranial pressure (author's transl)]

Nineteen patients with hydrocephalus or head injury were subjected to a continuous intraventricular pressure monitoring and received acetazolamide. Seven mg per Kg body-weight were infused intravenously in one minute. Three patterns of reactions were recorded: 1. a sharp and large rise in cerebrospinal fluid pressure 2. a moderate rise 3. no significant change in C.S.F. pressure. The mechanisms of these responses are investigated: metabolic CO2, which is normally converted rapidly to HCO3- through mediation of carbonic anhydrase within erythrocytes, builds up to produce an immediate effect of cerebral vasodilatation and increases C.S.F. pressure of patients with disturbed compensatory mechanisms. Intravenous acetazolamide may be used as a functional test in patients with ventricular enlargement and normal intracranial pressure. This technique provides useful data about the remaining compensatory capacity for further increases in intracranial volume.