Steroids and Brain Edema: Proceedings of an International Workshop, held in Mainz, W. Germany, June 19 to 21, 1972

The control of brain edema is still one of the major problems in surgical and conservative treatment of various cerebral lesions. Many attempts have been made to develop methods for reducing the high mortality associated with brain edema. Mter many years of using hypertonic solutions it can be stated that this type of therapy has not yielded satisfactory results. During recent years increasing evidence has been accumulated on the efficacy of steroids on brain edema. Steroids were reported to result in rapid relief of signs and symptoms of increased intracranial pressure and neurological dysfunction accompanying cerebral edema. It was the aim of this workshop to evaluate the effect of corticosteroids on brain edema as an advance in therapy. It was hoped that this could be achieved by a multi- disciplinary approach. Though, the volume contains the contributions of various experts - internists, neurochemists, neurologists, neuropathologists, neurosurgeons, pharmacologists, physiologists - who have added considerable experimental and clin- ical evidence on the action of steroids on brain edema. New pathophysiological aspects regarding the mechanisms underlying the formation and resolution of brain The effectiveness of corticosteroid therapy in various forms edema are presented. of clinical and experimental brain edema, e. g. accompanying brain tumors, head injury, spinal cord injury, cerebrovascular lesions, etc. as well as dosage and duration of treatment are critically discussed.

Table of Contents:
I. Experimental Aspects of Brain Edema and Therapeutic Approach.- Pathophysiological Aspects of Brain Edema.- Functional Aspects of Abnormal Protein Passage Across the Blood-Brain Barrier.- The Effects of Hypertonic Urea on the Blood-Brain Barrier and on the Glucose Transport in the Brain.- Molecular Aspects of Membrane Structure in Cerebral Edema.- Some Aspects of the Pharmacology of Adrenal Steroids and the Central Nervous System.- II. Effects of Steroids on Experimental Brain Edema.- Effects of Steroids on Cold Injury Edema.- The Effects of Glucosteroids upon Experimental Brain Edema.- The Influence of Dexamethasone on Water Content, Electrolytes, Blood-Brain Barrier and Glucose Metabolism in Cold Injury Edema.- Multiple Therapeutic Approaches in the Treatment of Brain Edema Induced by a Standard Cold Lesion.- Steroid-Induced Inhibition of Growth in Glial Tumors: a Kinetic Analysis.- Effects of Steroids on Edema Associated with Injury of the Spinal Cord.- Effect of Dexamethasone on Triethyl Tin Induced Brain Edema and the Early Edema in Cerebral Ischemia.- Effects of Ischemia on Water and Electrolyte Content of Cerebral Tissues.- Effect of Dexamethasone on the Early Edema Following Occlusion of the Middle Cerebral Artery in Cats.- III. Mechanisms of Action of Steroids on Brain Edema.- Physiology and Pathophysiology of Protein Permeability in the Central Nervous System.- Studies on the Mechanisms of Action of Steroids in Traumatized Brain.- Evidence Regarding the Action of Steroids in Injured Spinal Cord.- The Role of Necrosis and Inflammation in the Response of Cerebral Edema to Steroids.- Effect of Antioxidants on Experimental Cold-Induced Cerebral Edema.- Steroids and the Blood-Brain Barrier with Special Reference to Astrocytic Cells.- Adrenal Cortical Response toNeurosurgical Problems, Noting the Effects of Exogenous Steroids.- Physiological and Biochemical Findings in the Central Nervous System of Adrenalectomized Rats and Mice.- The Effect of Aldosterone and an Aldosterone-Antagonist on the Metabolism of Perifocal Brain Edema in Man.- IV. Effects of Steroids on Brain Edema in Man.- The Effects of Steroids on Brain Edema in Man.- The Clinical Effects of a Synthetic Gluco-Corticoid used for Brain Edema in the Practice of Neurosurgery.- Clinical Experiences with Steroids in Neurosurgical Patients.- The Effect of Dexamethasone on Water and Electrolyte Content and on rCBF in Perifocal Brain Edema in Man.- Clinical Studies on the Effect of Corticosteroids on the Ventricular Fluid Pressure.- Double Blind Study of the Effects of Dexamethasone on Acute Stroke.- Discussion to Chapter I.- Discussion to Chapter II.- Discussion to Chapter III.- Discussion to Chapter IV.- Round Table Discussion.