Dexametasona y edema cerebral peritumoral ¿Cuándo, cuánto y hasta cuándo?

Abstract

SUMMARY Steroids have been used since 1960, and even though they are associated with potential side effects, they play a decisive role in treating cerebral edema associated with primary or secondary brain tumors. On the other hand, steroids play a very important role within the initial management, considering that most tumors trigger vasogenic edema. We present the case of a 48-year-old woman with deviation of the labial commissure, left hemicorporal hemiparesis and somnolence secondary to a right temporal tumor; she was treated with dexamethasone 8 mg intravenously every eight hours, with the improvement of signs and symptoms (reversal of left fasciocorporal hemiparesis and improvement of the state of consciousness). Due to its pharmacological properties, dexamethasone is considered the steroid of choice for the treatment of peritumoral cerebral edema; it has a minimal mineralocorticoid effect, high potency and a longer half-life than the rest, although any other steroid could be effective if administered in equivalent doses. Currently, the dose, treatment time and ideal reduction scheme regarding the use of dexamethasone in the patient with cerebral peritumoral edema have not been defi ned, and the recommendations found are very different.