The Effect of Dexamethasone on the Edema of Focal Cerebral Ischemia

The effect of large dosages of dexamethasone on the edema of cerebral ischemia and infarction in the squirrel monkey after temporary occlusion of the middle cerebral artery is reported. There was no difference between the ten monkeys treated with dexamethasone and the 11 control animals in clinical course, mortality, morbidity, histological appearance, or amount of edema associated with this ischemic lesion. The differences in the electron microscopic and pathophysiological findings of the edema from ischemia secondary to single major vessel occlusion and in the edema from an intracranial mass lesion are reviewed. The possible therapeutic or pharmacological effects of steroids are considered along with available data on lysosomes in the brain. At the present time, there is no justification for the use of large doses of dexamethasone in the treatment of cerebral infarction.