Furosemide and Mannitol in the Treatment of Acute Experimental Intracranial Hypertension

Intracranial hypertension was induced in dogs and a small number of baboons by the inflation of epidural balloons. The resulting increased intracranial pressure (ICP) was treated with standard clinical doses of furosemide (0.7 mg/kg), "mini" doses of mannitol (0.75 g/kg), or both agents in combination, Mannitol consistently and rapidly reduced ICP in all animals. When results were averaged, furosemide used alone caused a slow reduction in ICP, but the results were variable in individual animals—with ICP actually increased in some. When furosemide and mannitol were given together, the ICP fell rapidly and remained low for considerably longer than after either agent alone. (Neurosurgery 12:405-410, 1983)