ROLE OF GLYCEROL IN CEREBROVASCULAR DISEASE

BACKGROUND New treatment modalities aimed to decrease both mortality and morbidity in patients with stroke are of the greatest necessity. The rationale for the use of glycerol in stroke is that brain edema is one of the most evident effects of ischemia and a common cause of death and morbidity. REVIEW SUMMARY In this review, we describe the basic mechanisms leading to accumulation of brain edema in stroke, followed by a discussion of the pharmacology of glycerol and its properties on brain hemodynamics and metabolism in both normal and pathologic circumstances. We also discuss all of the available trials in the English literature of glycerol for acute stroke. CONCLUSIONS Glycerol can be used safely to decrease the brain edema associated with ischemic stroke. However, its routine use has not been proven to significantly decrease morbidity or mortality in this setting. It is apparent that the beneficial effects of glycerol in brain ischemia cannot be explained solely on the basis of its hyperosmolar properties. (THE NEUROLOGIST 6:338-347, 2000)