Steroids in severe head injury: A prospective randomized clinical trial

Journal of Neurosurgery
T G SaulE Carro

Abstract

This is a prospective randomized study of the efficacy of steroid therapy in patients with severe head injury. One hundred patients were randomized into two equal groups: the steroid group received 5 mg/kg/day of methylprednisolone, and the nonsteroid group received no drug. The groups were similar in their clinical features. All patients received a standardized therapeutic regimen. The patients were also classified as early responders or nonresponders to the overall treatment protocol without regard to steroid administration, on the basis of change in Glasgow Coma Scale score during the first 3 days of admission. There was no statistically significant difference in the outcome of the steroid and nonsteroid group at 6 months. Of the responders who were on steroids, 74% had good outcomes or were disabled, compared with 56% of the responders who did not receive steroids. In the nonresponder group, the patients on steroids were actually associated with a worse outcome than those who did not receive steroids: 75% of the nonresponders who received steroids were dead or vegetative, compared to 56% of those who were not receiving steroids. The data suggest that: 1) the effect of steroids may be different for different patient groups; ...Continue Reading

References

Mar 1, 1975·Lancet·B Jennett, M Bond
Sep 1, 1979·Journal of Neurosurgery·P R CooperW Drane
Apr 1, 1979·Neurosurgery·B JennettT Kurze
Mar 1, 1979·Neurosurgery·F A SimeoneD P Becker
Feb 1, 1978·Journal of Neurosurgery·P A Tornheim, R L McLaurin
Dec 1, 1978·Journal of Neurology, Neurosurgery, and Psychiatry·J K YenA J Popp
Jul 13, 1974·Lancet·G Teasdale, B Jennett
Jan 1, 1972·Clinical Neurosurgery·E Alexander
Mar 1, 1970·Journal of Neurosurgery·P Gutterman, H A Shenkin
Aug 1, 1970·Archives of Neurology·V M BensonE C Foulkes

❮ Previous
Next ❯

Citations

Jan 1, 1995·Research in Experimental Medicine. Zeitschrift Für Die Gesamte Experimentelle Medizin Einschliesslich Experimenteller Chirurgie·T GrummeH Kostron
Jan 1, 1984·Canadian Anaesthetists' Society Journal·A W GelbQ J Durward
May 17, 1990·The New England Journal of Medicine·T B Ducker
Jun 4, 2002·Journal of Neurotrauma·Raj K NarayanLorraine Yurkewicz
May 22, 2007·Journal of Neurotrauma·Susan L BrattonDavid W Wright
Oct 11, 2005·Critical Care Medicine·Pejman CohanDaniel F Kelly
Aug 1, 2006·Critical Care Medicine·Edwin A Deitch, Saraswati D Dayal
Oct 1, 1995·Acta Anaesthesiologica Scandinavica·F NilssonC H Nordström
Apr 13, 1996·BMJ : British Medical Journal·D R Jeevaratnam, D K Menon
Sep 1, 1985·Archives of Emergency Medicine·J A Smith
Aug 1, 1993·Journal of Neurology, Neurosurgery, and Psychiatry·J D Pickard, M Czosnyka
Aug 14, 2001·American Journal of Respiratory and Critical Care Medicine·J J ProvencioA F Connors
Jan 27, 2012·Neurologia Medico-chirurgica·Minoru ShigemoriUNKNOWN Guidelines Committee on the Management of Severe Head Injury, Japan Society of Neurotraumatology
Mar 1, 1983·Journal of Neurosurgery·R BraakmanJ M Minderhoud
Nov 1, 1985·Journal of Neurosurgery·C S RobertsonJ C Goodman
Jan 1, 1986·Journal of Neurosurgery·N M DeardenM M Cameron
Jul 1, 1986·Journal of Neurosurgery·W C ClarkM W Ray
Dec 20, 2013·Cell and Tissue Research·Ellaine SalvadorCarola Förster
Jan 1, 1993·Intensive Care Medicine·J Pfenninger
Nov 21, 2012·Brain Injury : [BI]·Juan LuKate L Lapane
Jan 15, 2002·Neurological Research·Andrew I R Maas
Feb 12, 2017·Nature Reviews. Neurology·Dennis W SimonPatrick M Kochanek
Aug 1, 1997·Emergency Medicine Clinics of North America·R M Chesnut
Aug 13, 1998·Critical Care Clinics·C H Allen, J D Ward
Jul 1, 1989·JPEN. Journal of Parenteral and Enteral Nutrition·S H GreenblattJ W Geiger
Jan 28, 2005·The Cochrane Database of Systematic Reviews·P Alderson, I Roberts
Oct 27, 1997·Pediatric Annals·G B Zuckerman, E E Conway
Sep 23, 2016·Surgical Neurology International·Reid HoshideClark C Chen

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.