Canadian Journal of Anesthesia, Vol 15, 1-14, Copyright © 1968 by Canadian Anesthesiologists' Society

Le Metabolisme De L'Eau et Des Electrolytes En Neurologie et En Neurochirurgie

¹ Service de Neurochirurgie Institut Bunge, Berchem-Anvers, Belgique, et Département de Neurochimie Fondation Born-Bunge, Berchem-Anvers, Belgique

At the end of this paper, we would like to have succeeded in establishing some closer relations between the pathophysiological and clinical aspects on the one hand and the therapeutic on the other. That is difficult because the means of investigation at the patient's bedside are limited and, moreover, the observations done by anatomists and physiologists do not allow us to come to more than hypothetical conclusions.

The conclusions of the "Workshop on Brain Oedema" at Vienna, 1965, and of the Symposium on "Hemato-Encephalic Barrier" at Helversum, 1966, have shown that knowledge of the extracellular space and of cerebral oedema has made real progress. Otherwise, we can only regret that those results, obtained by research done by the most expensive means and with an extraordinary scientific precision, do not permit one to draw definite clinical conclusions.

Consequently, we will still have to work at the bedside for a while with the poor means of investigation that we actually have. Clinical observation allows us to say when one must ask for laboratory tests and what sort of dosage should be given. Prognosis will depend necessarily on the results obtained.

If such conclusions may seem a bit deceiving and discouraging, we must be stimulated by knowing that, thanks to such a therapeutic approach, we have often been able to treat postoperative hydro-ionic disorders successfully.