Acute intracranial hypertension occurring during infusion of stable plasma protein solution.

A case of traumatic cerebral oedema is reported in which the infusion of small volumes of stable plasma protein solution (SPPS) resulted in acute and massive increases in intracranial pressure. The batch of SPPS responsible was found to have high levels of prekallikrein activator which is thought to be the cause of the systemic hypotension previously described with plasma proteins solutions. A second batch of SPPS with low levels of prekallikrein activator generated much smaller increases in intracranial pressure. The mechanism of this phenomenon is discussed and a recommendation made for the cautious use of SPPS when intracranial hypertension is present or suspected.