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To Give or Not to Give

Arthur I. Kobrine, MD, PhD

JAMA. 1984;251(1):68.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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 . . . [Full Text PDF of this Article]

Author Affiliations
The George Washington University Medical Center Washington, DC

Footnotes
Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.

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