Glucocorticosteroid Treatment of Vasogenic Oedema

Summary

The components of vasogenic oedema associated with brain tumours were investigated in human biopsy material sampled from tumour and peritumoural tissue intraoperatively. Sixty patients with glioblastomas, gliomas, meningiomas and metastases, which had been treated with dexamethasone prior to surgery were employed for tissue measurements of water, electrolyte, haemoglobin, serum protein and dexamethasone concentrations. The quantification of serum proteins was achieved with the method described by Bodsch et al. Accordingly, serum proteins in the brain tissue and the blood were determined with 125 J labelled antihuman antibody. Taking into account brain haematocrit and blood-volume, quantitative measurements of the so-called oedema proteins as a measure of tumour oedema were performed. With the exception of metastases positive correlations were obtained between water and both serum proteins and sodium contents in tumours and peritumoural tissue. The serum protein content varied considerably being high in glioblastomas and low in peritumoural tissue surrounding metastases. However water and serum protein contents decreased with increasing dexamethasone concentrations in glioblastomas, while this effect was virtually absent in gliomas and meningiomas. Our results suggest a previously unknown selectivity among tumour types for the reduction of water content and serum proteins in corticosteroid treated oedematous tissue.