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The dogs with intracerebral bleeding were made to produce cerebral edema and high cerebrospinal fluid pressure. Steroids, urea and hypothermia were used for the treatment of resulted cerebral edema and elevated cerebrospinal fluid pressure. Results as follows: 1. Urea in 30% solution is very effective for the decrement of elevated CSFP, clinically and experimentally. The average value of it is about 50% of the initial pressure. From histological study the effect is also shown in reduction of cerebral edema. 2. From Fay hypothermia was introduced into neurosurgical treatment. Brain volume and high CSFP are reduced. Cerebral blood flow (CBF) and cerebral 02 consumption (CMRO2) are said to be also reduced. This is confirmed from my study in dogs with intracerebral bleeding. Below 32°-30°C, CBF and CMRO2 line become rather horizontal. From this, I conclude that the lower limit of the cooling must be decided between these. In normal dogs this limit exist between 30°-28°C. Therefore it is important practically that in pathological states or head injury, brain tumor etc., lower limit appears 2°-4°C higher than in normal state. 3. Premedicated dogs with dexamethasone present moderately good values in above mentioned experiments, especially in CMR02 and crebral arteries venous 02 difference (A-V02). Systolic blood pressure is also hold at high level than injured dogs. 4. Histological examination of the 2 groups shows remarkable difference and the application of hypothermia and steroids have a good effect for the reduction of cerebral edema.

E5. The Medical Treatment of Cerebral Edema with Steroids, Urea and Hypothermia