The Effect of Various Steroid Treatment Regimens on Cold-induced Brain Swelling

  • A. W. Unterberg
  • W. Schmidt
  • C. Dautermann
  • A. Baethmann
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 51)


M.D. The role of steroid therapy in brain oedema following acute cerebral lesions is still unsolved. This study was conducted to compare the efficacy of dexamethasone and triamcinolone, and to analyze the influence of timing and duration of treatment on cold-induced brain swelling.

In rabbits, a cryogenic lesion of the left parietal cortex was induced. 24, or 48 hrs after trauma, hemispheric swelling, water- and electrolyte-contents were measured. A first series of animals received dexamethasone, triamcinolone or saline for 24 hrs, starting treatment 10 min after trauma. In a second series, steroid treatment lasted 48 hrs and in a third series the animals were additionally pretreated for 24 hrs.

Dexamethasone and triamcinolone slightly decreased posttraumatie hemispheric swelling, from 7.7% in controls to 7.0% in treated animals. There was no significant difference between dexamethasone and triamcinolone. Reduction of swelling was most pronounced in animals with 48 hrs treatment. Pretreatment with steroids was not superior to early posttraumatic treatment. On the other hand, dexamethasone and triamcinolone significantly decreased cerebral water content in the traumatized and contralateral hemisphere, as well as in non-traumatized animals.

The unspecific reduction of water content by steroids in rabbits might explain the moderate therapeutical effect on brain swelling. This effect might be beneficial, nevertheless, with respect to an improvement of the intracranial compliance.


Brain Oedema Steroid Treatment Contralateral Hemisphere Cold Injury Intracranial Compliance 


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  1. 1.
    Baethmann A (1985) Steroids and brain function. In: James HE, Anas NG, Perkin RM (eds) Brain insult in infants and children: Pathophysiology and management. Grune & Stratton, Orlando, pp 3–17Google Scholar
  2. 2.
    Braakman R, Schouten HJA, Blaauw-van Dishoeck M, Minderhoud JM (1983) Megadose steroids in severe head injury.Results of a prospective double-blind clinical trial. J Neurosurg 58: 326–330PubMedCrossRefGoogle Scholar
  3. 3.
    Herrmann HD, Neuenfeldt D, Dittmann J, Palleske H (1972) The influence of dexamethasone on water content, electrolytes, blood-brain barrier and glucose metabolism in cold injury oedema. In: Reulen HJ, Schürmann K (eds) Steroids and brain oedema. Springer, Berlin Heidelberg New York, pp 77–85CrossRefGoogle Scholar
  4. 4.
    Pappius HM (1969) Effects of steroids on cold injury oedema. In: Reulen HJ, Schürmann K (eds) Steroids and brain oedema. Springer, Berlin Heidelberg New York, pp 57–63Google Scholar
  5. 5.
    Raimondi AJ, Clasen RA, Beattie EJ, Taylor CB (1959) The effect of hypothermia and steroid therapy on experimental cerebral injury. Surg Gynecol Obstet 108: 333–338PubMedGoogle Scholar
  6. 6.
    Reulen HJ, Schürmann K (1972) Steroids and brain oedema. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  7. 7.
    Schilling L (1984) Wirkung von Di-Natrium-DexamethasonPhosphat und Di-Kalium-Triamcinolon-Acetonid-Phosphat auf das Hirnödem nach Kälteläsion. Thesis, MainzGoogle Scholar
  8. 8.
    Sugiura K, Kanazawa C, Muraoka K, Yoshino Y (1980) Effect of steroid therapy on cerebral cold injury oedema in the rat. The optimal dosage. Surg Neurol 13: 301–305Google Scholar
  9. 9.
    Unterberg A, Dautermann C, Müller-Esterl W, Baethmann A (1986) The kallikrein-kinin system as mediator in vasogenic brain oedema. III: Inhibition of the kallikrein-kinin system in traumatic brain swelling. J Neurosurg 64: 269–279PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • A. W. Unterberg
    • 3
  • W. Schmidt
    • 1
    • 2
  • C. Dautermann
    • 1
    • 2
  • A. Baethmann
    • 1
    • 2
  1. 1.Department NeurosurgeryUniversitätsklinikum Rudolf Virchow, Free University of BerlinFederal Republic of Germany
  2. 2.Institute Surgical Research, Klinikum GroßhadernUniversity of MunichFederal Republic of Germany
  3. 3.Department Neurosurgery, Rudolf Virchow Medical CenterFree University of BerlinBerlin 65Germany

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