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The Question of Steroids in Neurotrauma: Title and subTitle BreakTo Give or Not to Give FREE

Arthur I. Kobrine, MD, PhD
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JAMA. 1984;251(1):68-68. doi:10.1001/jama.1984.03340250048021
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Steroids have been used extensively in neurological surgery since 1951, when Galicich and co-workers1 first introduced them. Initially they were used only in treating patients with brain tumors and were shown to have a tremendously beneficial effect in reducing the cerebral edema surrounding such lesions, often with remarkable decreases in neurological deficit. Later, their use was extended to all elective neurosurgical procedures. This was done under the premise that steroids would reduce the perioperative brain swelling that accompanied most neurosurgical procedures. In fact, steroid treatment has substantially decreased the operative morbidity and mortality accompanying lesions in and around the pituitary gland, as well as morbidity and mortality associated with operative intervention for meningiomas, gliomas, and other brain tumors. As neurosurgeons embraced the use of steroids given for systemic effects, neurotrauma became an indication for steroid treatment. Patients with closed head injury have been treated with small-dose, large-dose, and megadose

REFERENCES

Galicich JH, French, LA, Melby JC:  Use of dexamethasone in treatment of cerebral edema associated with brain tumors . J Lancet 1961;;81:46-53.
Cooper PR, Moody S, Clark WK:  Dexamethasone and severe head injury: A prospective double blind study . J Neurosurg 1979;;51:307-316.
Braakman R, Schouten HJ, Blaauw-van Dishoeck M, et al:  Megadose steroids in severe head injury . J Neurosurg 1983;;58:326-330.
Ducker TB, Hamit HF:  Experimental treatments of acute spinal cord injury . J Neurosurg 1969;;30:693-697.

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Galicich JH, French, LA, Melby JC:  Use of dexamethasone in treatment of cerebral edema associated with brain tumors . J Lancet 1961;;81:46-53.
Cooper PR, Moody S, Clark WK:  Dexamethasone and severe head injury: A prospective double blind study . J Neurosurg 1979;;51:307-316.
Braakman R, Schouten HJ, Blaauw-van Dishoeck M, et al:  Megadose steroids in severe head injury . J Neurosurg 1983;;58:326-330.
Ducker TB, Hamit HF:  Experimental treatments of acute spinal cord injury . J Neurosurg 1969;;30:693-697.
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