Glucocorticoid therapy in neurologic critical care

Joao A. Gomes, Robert D. Stevens, John J. Lewin, Marek A. Mirski, Anish Bhardwaj

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: The pivotal role of inflammation and edema across the spectrum of central nervous system injury has driven extensive investigation into the therapeutic potential of glucocorticoids. Objective: To review the experimental and clinical data relating to the efficacy and adverse effects of glucocorticoids in conditions encountered in critical neurologic and neurosurgical illness. Data Source: Search of MEDLINE and Cochrane databases, manual review of article bibliographies. Data Synthesis and Conclusions: The efficacy of glucocorticoids is well established in ameliorating edema associated with brain tumors and in improving outcome in subsets of patients with bacterial meningitis. Despite frequently encouraging experimental results, clinical trials of glucocorticoids in ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, and traumatic brain injury have not shown a definite therapeutic effect. The evidence supporting glucocorticoid therapy for spinal cord injury is controversial; however methylprednisolone continues to be widely employed in this setting.

Original languageEnglish (US)
Pages (from-to)1214-1224
Number of pages11
JournalCritical Care Medicine
Volume33
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

Fingerprint

Critical Care
Nervous System
Glucocorticoids
Edema
Nervous System Trauma
Therapeutics
Bacterial Meningitides
Information Storage and Retrieval
Methylprednisolone
Cerebral Hemorrhage
Bibliography
Therapeutic Uses
Subarachnoid Hemorrhage
Spinal Cord Injuries
MEDLINE
Brain Neoplasms
Central Nervous System
Stroke
Clinical Trials
Databases

Keywords

  • Brain injury
  • Glucocorticoids
  • Inflammation
  • Neurologic critical care

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Glucocorticoid therapy in neurologic critical care. / Gomes, Joao A.; Stevens, Robert D.; Lewin, John J.; Mirski, Marek A.; Bhardwaj, Anish.

In: Critical Care Medicine, Vol. 33, No. 6, 06.2005, p. 1214-1224.

Research output: Contribution to journalArticle

Gomes, Joao A. ; Stevens, Robert D. ; Lewin, John J. ; Mirski, Marek A. ; Bhardwaj, Anish. / Glucocorticoid therapy in neurologic critical care. In: Critical Care Medicine. 2005 ; Vol. 33, No. 6. pp. 1214-1224.
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