Osmotherapy in Acute Ischemic Stroke
Anish Bhardwaj, M.D. – Principal Investigator

 
Cerebral edema associated with large hemispheric infarctions is frequently encountered in clinical practice and is a major cause of disease and even death. 

Clinically, osmotherapy is the mainstay of medical management of cerebral edema associated with ischemic stroke.  While mannitol has been the conventional osmotic agent of choice, its therapeutic efficacy is limited due to several adverse side effects.  A few experimental studies and clinical case series suggest that hypertonic saline (HS) is efficacious in the treatment of cerebral edema in some brain injury paradigms, but its effects in ischemic stroke are not well studied.

The overall goal of this research project is to test the hypothesis that institution and maintenance of a hyper-osmolar state with HS is an important treatment of cerebral edema following experimental ischemic stroke.  We will also utilize HS as a tool to enhance our understanding of the complex mechanisms of edema formation following ischemic stroke, particular delineating the role of recently discovered water channels (aquaporins) and interaction with the neurohormone, arginine-vasopressin.  We anticipate that findings from this research will provide insights into new therapeutic targets and strategies for cerebral edema associated with ischemic stroke.

This research is funded by the National Institutes of Health.