Effect of glucocorticoids on ICP in patients with a cerebral tumour.
Preoperative treatment with glucocorticoids in patients with an intracranial tumour has been neurosurgical practice for more than 30 years. Recently, however, a less beneficial effect in patients with a meningeoma is reported. This study included 4 patients with a glioma, 4 with a metastasis and 5 with a meningeoma. All patients had a substantial amount of oedema. The effect of methylprednisolone was monitored during 5 days by clinical examination and epidural pressure measurement. ICP reduction was found in 4 of 13 patients. All observations of decreasing pressure were in patients with a malignant tumour and an initial ICP > 15 mmHg. All 4 patients improved clinically. Another 4 patients with a benign meningioma had a significant increase of ICP and none of them experienced clinical improvement. Clinical deterioration was not observed in any patient despite increasing ICP in some cases. In summary, a beneficial effect of GC was demonstrated only in patients with a malignant tumour and augmented pre-treatment ICP.
Skjoeth
J
J
Neurosurgery Department, Odense University Hospital, Denmark.
Bjerre
P K
PK
D001929:Brain Edema / Q000188:drug therapy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005910:Glioma / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects*; D008577:Meningeal Neoplasms / Q000188:drug therapy*; D008579:Meningioma / Q000188:drug therapy*; D008775:Methylprednisolone / Q000008:administration & dosage*; D008991:Monitoring, Physiologic; D009460:Neurologic Examination / Q000187:drug effects; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D008775:Methylprednisolone