“… findings support current guidelines against routine use, but strong recommendations are not warranted because confidence in the effect estimates is limited.” Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Systematic Review and Meta-Analysis. Evaniew et al. Journal of Neurotrauma, Feb. 2016. Link to the abstract here.
Published in 2013, the joint CNS/AANS Guidelines for the first time discourage the use of steroids for traumatic spinal cord injury. This comes after a thorough review of existing evidence and a critical re-examination of the NASCIS-studies previously interpreted as favouring steroid use. “In summary, there is no consistent or compelling medical evidence of any… Continue reading Steroids and Spinal Cord Injury – Excerpts From the Joint CNS/AANS Guideline
The most updated review by the Cochrane Collaboration on steroid use and traumatic brain injury. The vast majority of patients stem from the CRASH trial. “In the absence of a meta-analysis, we feel most weight should be placed on the result of the largest trial. The increase in mortality with steroids in this trial suggest… Continue reading Cochrane Review – Steroids and TBI
Well known and must-read paper on the use of steroid cover in TBI patients. It is by far the largest trial on this subject and still forms the basis for today’s recommendations that steroids not be used in this patient group. Published in the Lancet 2005. “The risk of death was higher in the corticosteroid… Continue reading CRASH Trial on Steroids and TBI