The inability of mannitol to reduce intracranial pressure is closely related to the cause of intracranial hypertension, treatment, and also to renal function.
For mild to moderate intracranial hypertension caused by large cerebral infarction, cerebral hemorrhage, and subarachnoid cavernous causes, intracranial pressure can be lowered by mannitol, but for severe intracranial hypertension, surgical methods such as decompression of desmoid flap need to be given to lower the intracranial pressure.
If it is caused by a brain tumor, because of the persistence of intracranial compression, the effect of mannitol in lowering intracranial pressure will not be obvious, and surgical treatment is needed to release the compression to effectively reduce the cranial pressure. If the elevated intracranial pressure is caused by venous sinus stenosis, surgery is needed to place stents in the blood vessels to restore blood flow in order to effectively reduce intracranial pressure.
It is also related to the patient’s renal function; if the patient has renal insufficiency, the use of mannitol aggravates the renal insufficiency, thus affecting the effect of dehydration and failing to reduce intracranial pressure.
To summarize, after the discovery of increased intracranial pressure, we need to cooperate with the doctor to improve the examination, to clarify the causes of increased intracranial pressure, and then carry out symptomatic treatment under the guidance of the doctor, to avoid delaying the condition.