Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage

Feigin, V L; Anderson, Neil E.; Rinkel, G. J. E.; Algra, Ale; Gijn, J. van; Bennett, Derrick

doi:10.1002/14651858.cd004583

Cited by 42 publications

(53 citation statements)

References 25 publications

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“…This form of analysis is unprecedented in similar outcome trials, and hence, the conclusions based on this analysis cannot be taken at face value. In summary, the existing data suggest that effect of corticosteroid replacement ranges from harmful to no benefit in outcome [24].…”

Section: Hormonal Replacement Therapy For Sahmentioning

confidence: 96%

Endocrine Function Following Acute SAH

Vespa

2011

Neurocrit Care

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Disruption of the hypothalamic-pituitary-adrenal axes may occur after aneurysmal subarachnoid hemorrhage, resulting in hypopituitarism. An electronic literature search was conducted to identify articles with English-language abstracts published between 1980 and March 2011, which addressed hypothalamic-pituitary-adrenal axis insufficiency and hormone replacement. A total of 18 observational and prospective, randomized studies were selected for this review. Limited data are available, evaluating pituitary effects during the acute stage after subarachnoid hemorrhage, with inconsistent results being reported. Overall, after acute subarachnoid hemorrhage, cortisol levels may initially be supranormal, decreasing toward normal levels over time. During the months to years after subarachnoid hemorrhage, pituitary deficiency may occur in one out of three patients. Limited data suggest modest outcome benefits with fludrocortisone and no benefit or harm from corticosteroids.

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Section: Hormonal Replacement Therapy For Sahmentioning

confidence: 96%

Endocrine Function Following Acute SAH

Vespa

2011

Neurocrit Care

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“…However it is well known that they have a series of dangerous side effects, mostly increased risk of gastro-intestinal bleeding, infections and diabetes. A meta-analysis of three trials of steroids in SAH was unable to demonstrate evidence of either benefit or harm [24]. If steroids (e.g.…”

Section: Steroidsmentioning

confidence: 99%

Update on subarachnoid haemorrhage

2008

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Subarachnoid haemorrhage (SAH) is less frequent than ischaemic stroke or intracerebral haemorrhage, but has a high public health relevance because it can affect young and middle-age adults, has considerable mortality and morbidity, it is treatable and preventable. SAH is traditionally a topic for neurosurgeons. However as endovascular interventions are becoming effective alternatives to surgical treatment, SAH should turn out to be of interest to neurologists, in particular to those devoted to stroke, emergency and neurointensive care. Despite stable incidence, the mortality of SAH has decreased in the last two decades due to better neurosurgical techniques and neurocritical care and to advances in interventional neuroradiological procedures. We review the recent advances in the clinical and diagnostic aspects of SAH and in the genetics of intracranial aneurysms. A systematic review of the treatment of SAH and grading of the available evidence is included.

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“…Randomized controlled trials have never proven that dexamethasone can contain the perihematomal infl ammatory response and reduce edema. The 2005 Cochrane analysis of the use of corticosteroids for primary ICH found insuffi cient evidence to draw any meaningful conclusions [33].…”

Section: Fast Hematoma Expansion and Clinical Outcomementioning

confidence: 99%

Treatment of intracerebral hemorrhage: What should we do now?

Wang

Talkad²

2008

Curr Neurol Neurosci Rep

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Intracerebral hemorrhage (ICH) is the most lethal type of stroke. Level I, class A evidence of effective treatment is lacking. Many issues surrounding the optimal management of ICH, such as blood pressure control, prevention of hematoma growth, containing brain edema, and preserving cerebral perfusion, need more rigorous clinical research. However, when selected appropriately, the mortality of certain patients with ICH may improve when treated early with minimally invasive neurosurgery or perhaps intravenous hemostatics. In addition, patients with ICHs may have better outcome when medical care is optimized according to the published ICH treatment guidelines. Stem cell therapy has shown promise for better functional recovery.

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Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage

Cited by 42 publications

References 25 publications

Endocrine Function Following Acute SAH

Endocrine Function Following Acute SAH

Update on subarachnoid haemorrhage

Treatment of intracerebral hemorrhage: What should we do now?

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