Epidural hematomas can be treated with mannitol before the patient decides to undergo craniotomy or if the intracranial bleeding has stopped and there are signs of increased intracranial pressure.
During the hemorrhagic phase of an epidural hematoma, most of the time there is an increase in intracranial pressure, and it is this increase in intracranial pressure that has a tamponade effect on the hematoma, slowing down or stopping the bleeding.
If the application of mannitol, due to the dehydrating effect of mannitol, can reduce the volume of the brain, reduce the cranial pressure, will cause this filler effect disappeared, which will make the intracranial hemorrhage continue to increase, aggravate the patient’s condition. Therefore, patients with epidural hematoma should use mannitol to reduce intracranial pressure only after the bleeding stops.
For subdural hematoma with impaired consciousness requiring surgery, mannitol and furosemide should be applied as early as possible to complete the preoperative preparation.