Corticosteroids in ischemic stroke

The authors have attempted to summarize current concepts of ischemic cerebral edema and the evidence that corticosteroids influence its course. At the same time the authors have reviewed available information regarding the effects of corticosteroids on other processes of ischemic infarction in both animal models and humans. While the available evidence does not support the indiscriminate use of corticosteroids in ischemic infarction, they may be valuable in some situations, particularly those patients with large infarcts. Future studies incorporating more direct measures of the effects of corticosteroids on cerebral edema should help to resolve the question. Additionally, corticosteroids may be effective in combinations with other drugs, particularly diuretics, or when administered alone in extremely high dosage.