Brain Inflammation and Steroids: Two Double-Edged Swords

Editorials1 January 1969Brain Inflammation and Steroids: Two Double-Edged SwordsJAMES F. TOOLE, M.D., F.A.C.P., CHARLES E. MCCALL, M.D.JAMES F. TOOLE, M.D., F.A.C.P.Search for more papers by this author, CHARLES E. MCCALL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-1-221 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInflammation, whatever its cause, is a double-edged sword that can be a help or a hindrance to the tissue in which it occurs (1). In the central nervous system, for example, beneficial and harmful effects are hard to separate because certain elements of inflammation can cause disaster—edema often results in death, and adhesions may interfere with the secretion, circulation, and resorption of cerebrospinal fluid. Patients with bacterial meningitis, even when treated early with appropriate antibiotics, frequently die or are permanently crippled by these secondary effects (2). In efforts to reduce these undesirable elements and sequels of central nervous system inflammation,...References1. SPECTORWILLOUGHBY WGDA: The inflammatory response. Bact. Rev. 27: 117, 1963. CrossrefMedlineGoogle Scholar2. DODGESWARTZ PRMN: Bacterial meningitis—a review of selected aspects. II. Special neurologic problems, postmeningitic complications and clinicopathological correlations. New Eng. J. Med. 272: 1003, 1965. CrossrefMedlineGoogle Scholar3. ALLISON F: "Anti-inflammatory agents," in The Inflammatory Process, edited by ZWEIFACH, B. W., GRANT, L., MCCLUSKEY, R. T., Academic Press, Inc., Publishers, New York and London, 1965, pp. 569-573. CrossrefGoogle Scholar4. KASSFINLAND EHM: Adrenocortical hormones in infection and immunity. Ann. Rev. Microbiol. 7: 361, 1953. CrossrefMedlineGoogle Scholar5. FAUVEPIERCE-CHASE RMCH: Comparative effects of corticosteroids on host resistance to infection in relation to chemical structure. J. Exp. Med. 127: 807, 1968. Google Scholar6. : The effectiveness of hydrocortisone in the management of severe infections: a double blind study. JAMA 183: 462, 1963. CrossrefGoogle Scholar7. THORNTONO'TOOLEMUKHERJEENATH GFRDMKRL: Adrenocorticosteroids in treatment of pneumococcal meningitis (abstract). Clin. Res. 16: 335, 1968. Google Scholar8. FRENCH LA: The use of steroids in the treatment of cerebral edema. Bull. NY Acad. Med. 42: 301, 1966. MedlineGoogle Scholar9. WILLIAMSSWANSONCHAPMAN CPAGJT: Brain swelling with acute purulent meningitis. Report of treatment with hypertonic intravenous urea. Pediatrics 34: 220, 1964. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bowman Gray School of Medicine Winston-Salem, N. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySenescence and life spanDecadron in the treatment of cerebral abscessMiliary tuberculosisManagement of acute necrotizing encephalitisEffectiveness of Betamethasone in Management of Severe InfectionsEvaluation of Corticosteroids in Treatment of Tuberculous Meningitis 1 January 1969Volume 70, Issue 1Page: 221-222KeywordsAntibioticsBacterial meningitisCentral nervous systemCerebrospinal fluidEncephalitisInflammationSteroids Issue Published: 1 January 1969 PDF DownloadLoading ...