Effect of steroids on intracranial pressure and pressure-volume index in patients with hydrocephalus

It is well-established that steroids (glucocorticoids) have a beneficial clinical effects on patients with increased intracranial pressure, but there is still a controversy on the mode of action of steroids. The purpose of this study is to investigate the effects of steroids on continuous intracranial pressure and on intracranial compliance using pressure-volume index (PVI). Thirteen hydrocephalic patients, ranging from 9 to 70 years old, without intracranial mass lesion nor brain edema were studied. The patients were divided into two groups. Group I: Five patients were monitored the continuous intracranial pressure for 24 hours again following the administration of steroids on continuous intracranial pressure. The method of the administration of steroids was that betamethasone 8 mg for initial dose was administered intravenously and followed by 4 mg intramuscularly every 6 hours. There was little change in the baseline pressure and the amplitude on continuous intracranial pressure monitoring before and after the administration of steroids. But the maximum pressure and the maximum amplitude significantly decreased after the administration of steroids. The % time B-wave and the maximum continuous time of B-wave also decreased significantly. Group II: Eight patients were studied in order to investigate the effects of steroids on the intracranial compliance. PVI was measured according to Marmarou's method before and after the intravenous administration of steroids (beta-methasone 0.5 mg/kg). PVI increased in 7 out of 8 cases after the administration of steroids, which was statistically significant. It can be concluded that steroids increase the intracranial compliance and inhibit the rise of intracranial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)