Dexamethasone for brain tumor treatment [Neurosurgery Wiki]

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====== Dexamethasone for brain tumor treatment ======

 for patients not previously on steroids:

○ adult: 10 mg IVP loading, then 6 mg PO/IVP q 6 hrs
((Galicich JH, French LA. Use of Dexamethasone in the Treatment of Cerebral Edema Resulting from Brain Tumors and Brain Surgery. Am Pract Dig Treat. 1961; 12:169–174))
((French LA, Galicich JH. The Use of Steroids for Control of Cerebral Edema. Clin Neurosurg. 1964; 10:212–223))
In cases with severe [[vasogenic edema]], doses up to 10 mg q 4 hrs may be used

○ peds: 0.5–1 mg/kg IVP loading, then 0.25–0.5 mg/kg/d PO/IVP divided q 6 hrs. NB: avoid prolonged treatment because of growth suppressant effect in children

● for patients already on steroids:

○ for acute deterioration, a dose of approximately double the usual dose should be tried
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[[Vasogenic edema]]: [[blood-brain barrier]] disrupted. [[Protein]] (serum) leaks out of the vascular system and therefore may enhance imaging. Extracellular space (ECS) expands. Cells are stable. Responds to [[corticosteroid]]s (e.g. dexamethasone). Seen e.g. surrounding [[brain metastases]].

see [[Dexamethasone for brain metastases]]
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