Advertisement

Steroids

  • Jens Jakob Riis
Chapter

Abstract

Corticosteroids to brain trauma patients have for a long time been an important and controversial topic; so far, there has not been consensus regarding the possible benefits or adverse effects of administration of corticosteroids to such patients. High-dose methylprednisolone to patients with trauma-induced spinal transection has been abandoned in many Nordic trauma centres due to (1) lack of evidence for beneficial effect, (2) harmful effect on brain trauma patients with spinal cord injuries, and (3) the significant side effects, e.g. hyperglycaemia, gastric ulcers/bleeding, increased risk of infection, psychosis and impairment of wound healing (Poungvarin 2004).

Keywords

Spinal Cord Injury Trauma Patient Brain Oedema Controversial Topic Significant Side Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Alderson P, Roberts I (1997) Corticosteroids in acute traumatic brain injury: systematic review of randomised controlled trials. Br Med J 314:1855–1859CrossRefGoogle Scholar
  2. Alderson P, Roberts IG (2005) Corticosteroids for acute traumatic brain injury. Cochrane Database Syst Rev (1):CD000196. doi: 10.1002/14651858.CD000196.pub.2Google Scholar
  3. Audibert G, Baumann A et al (2009) Deleterious role of hyperthermia in neurocritical care. Ann Fr Anesth Reanim 28(4):345–351PubMedCrossRefGoogle Scholar
  4. Dearden NM, Gibson JS et al (1986) Effect of high-dose dexamethasone on outcome from severe head injury. J Neurosurg 64:81–88PubMedCrossRefGoogle Scholar
  5. Giannotti SL, Weiss MH et al (1984) High dose glucocorticosteroids in the management of severe head injury. Neurosurgery 15:497–501CrossRefGoogle Scholar
  6. Ginsbury MD, Busto R (2003) Combating hyperthermia in acute stroke: a significant clinical concern. Stroke 34(1):5–6CrossRefGoogle Scholar
  7. Grände PO (2006) The “Lund concept” for the treatment of severe head trauma – physiological principles and clinical applications. Intensive Care Med 32:1475–1484PubMedCrossRefGoogle Scholar
  8. Jeremitsky E, Omert LA et al (2005) The impact of hyperglycaemia on patients with severe head injury. J Trauma 58:47–50PubMedCrossRefGoogle Scholar
  9. Kamano S (2000) Are steroids really ineffective for severely head injured patients? Neurosurg Focus 8(1):Article 7CrossRefGoogle Scholar
  10. Laird AM, Miller PR (2004) Relationship of early hyperglycaemia to mortality in trauma patients. J Trauma 56(5):1058–1060PubMedCrossRefGoogle Scholar
  11. Papadopoulos MC, Saadoun S et al (2004) Molecular mechanisms of brain tumour edema. Neuroscience 129:1011–1020PubMedCrossRefGoogle Scholar
  12. Poldermann KH (2008) Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet 371(9628):1955–1969CrossRefGoogle Scholar
  13. Poldermann KH, Herold I (2009) Therapeutic hypothermia and controlled normothermia in the intensive care unit: practical considerations, side effects and cooling methods. Crit Care Med 37:1101–1120CrossRefGoogle Scholar
  14. Poungvarin N (2004) Steroids has no role in stroke therapy. Stroke 35:229–230PubMedCrossRefGoogle Scholar
  15. Rabinstein AA (2006) Treatment of brain edema. Neurologist 12:59–73PubMedCrossRefGoogle Scholar
  16. Raslan A, Bhardwaj A (2007) Medical management of cerebral edema. Neurosurg Focus 22(5):E12:1–E12:9CrossRefGoogle Scholar
  17. Roberts I, Yates D et al (2004) Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRS CRASH-trial). Lancet 364:1321–1328PubMedCrossRefGoogle Scholar
  18. Rovlias A, Kotsou S (2000) The influence of hyperglycaemia on neurological outcome in patients with severe head injury. Neurosurgery 46:335–343PubMedCrossRefGoogle Scholar
  19. Salim A, Hadjizachoria A et al (2009) Persistent hyperglycaemia in severe traumatic brain injury; an independent predictor of outcome. Am Surg 75(1):25–29PubMedGoogle Scholar
  20. Sinha S, Bastin ME et al (2004) Effect of dexamethasone on peritumoural oedematous brain: a DT-MRI study. J Neurol Neurosurg Psychiatry 75:1632–1635PubMedCrossRefGoogle Scholar
  21. Yag B, Ott L et al (1989) Relationship between admission hyperglycaemia and neurologic outcome of severely brain injured patients. Ann Surg 210(4):466–472CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of NeurosurgeryAarhus Aaarhus University HospitalAarhusDenmark

Personalised recommendations