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Annu Rev Med. 1993;44:289-301.

Control of brain volume during hyperosmolar and hypoosmolar conditions.

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Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.


The brain is particularly vulnerable to disturbances of body fluid osmolality. Studies in animals indicate that brain adaptation to osmotic stresses is a very complex process involving transient changes in water content and sustained changes in electrolyte and organic osmolyte contents. Appreciation of the nature of the adaptation process enables a better understanding of the marked variations in neurological sequelae that characterize hyper- and hypoosmolar states and provides a basis for more rational therapy.

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