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The complications of high‐dose corticosteroid therapy in neurosurgical patients: A prospective study
Author(s) -
Marshall Lawrence F.,
King Joseph,
Langfitt Thomas W.
Publication year - 1977
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410010220
Subject(s) - medicine , corticosteroid , dexamethasone , antacid , incidence (geometry) , surgery , prospective cohort study , complication , anesthesia , optics , physics
We studied prospectively the complications of high‐dose corticosteroid administration in 121 consecutive neurosurgical patients. Dexamethasone was begun in a daily dosage of 16 mg in 36 patients, 40 mg in 43 patients, and 80 mg in 42 patients, with an antacid, and was appropriately tapered. There were three major complications (incidence, 2.4%), with 1 death definitely attributable to corticosteroid therapy (0.8%). Two of the major complications occurred in patients with previous or concurrent upper gastrointestinal disease. Nineteen patients who were maintained on long‐term (mean 206 – 56 days) daily doses of 40 mg or more for the treatment of malignant brain tumors remained free of complications. There was no evidence that increased intracranial pressure, diminished level of consciousness, or higher dosage schedules increased the risk. High‐dose dexamethasone therapy is safe in neurosurgical patients. One must use caution, however, when the history suggests gastrointestinal erosive disease.