Summary
In order to determine, by CT density and volume measurements, the influence of steroid therapy on cerebral tumors, on their perifocal edema and on the uninvolved cerebral tissue, CT follow-up studies of 37 patients were analysed. In general a decrease of tumor density is to be seen within the first 10 days of therapy. Under continuous steroid application absorption coefficients then increase again, so that no cortisone effect on the tumor remains. The tumor size does not alter: in particular at no time is growth retardation detectable under cortisone therapy. Intensity and extension of the perifocal edema decrease in two stages. From this delayed course we conclude the cytotoxic component of the tumor edema to be more extensive than supposed. Deviations appear dependent on tumor histology, which should lead to individualied steroid application.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baethmann A (1979) Das Hirnödem mechanischer, zirkulatorischer, osmotischer, metabolischer und toxischer Genese. In: Klinische Anaesthesiologie und Intensivtherapie, Bd 19. Springer, Berlin Heidelberg New York
Baethmann A, Oettinger W, Rothenfusser W, Geiger R, Mann K (1977) Chemical mediator compounds in brain edema. Eur Surg Res [Suppl] 9: 121 ff.
Bazan NG (1979) Membrane lipids in the pathogenesis of brain edema. 1st International Ernst-Reuter Symposium. 12–15 September Berlin
Bergström M, Sunderman R (1976) Picture processing in computed tomography. AJR 127: 17–21
Blomstrand C, Johannson B, Rosengren B (1975) Dexamethasone effect on blood brain barrier damage caused by acute hypertension in X-irradiated rabbits. Acta Neurol Scand 52: 331–334
Booz K-H, Desaga U (1977) Untersuchungen am Ependym der Ratte nach Erzeugung eines Hirnödems bzw. Hydrocephalus internus. Ver Anat Ges 71:1009–1014
Crocker EF, Zimmerman RA, Phelps ME, Kuhl DE (1976) The effect of steroids on the extravascular distribution of radiographic contrast material and technetium Pertechnetate in brain tumors as determined by computed tomography. Radiology 119: 471–474
Demopoulos H, Miloy P, Kakris S, Ransohoff J (1972) Molecular aspects of membrane structure in cerebral edema. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York
Drayer BP, Rosenbaum AE (1979) Brain edema defined by cranial computed tomography. J Comput Assist Tomogr 3: 317–323
Enzmann DR, Britt RH, Yeager AS (1979) Experimental brain abscess evolution: computed tomographic and neuropathologic correlation. Radiology 133: 113–122
Fishman RA (1975) Brain edema. N Engl J Med 293: 706–711
Gabourel J, Aronow L (1962) Growth inhibitory effects of hydrocortisone on mouse lymphoma ML 388 in vitro. J Pharmacol Exp Ther 136: 213–221
Herrmann HD, Neuenfeldt D, Dittmann J, Palleske H (1972) The influence of dexamethasone on water content, electrolytes, BBB and glucose metabolism in cold injury edema. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York
Hossmann K, Wilms F, Blöink M (1979) Experimental peritumorous edema of the cat brain. 1st International Ernst-Reuter Symposium, 12–15 September, Berlin
Kaiser H (1977) Cortisonderivate in Klinik und Praxis, 7. Aufl. Thieme, Stuttgart New York
Kazner E, Wende S, Grumme Th, Lanksch W, Stochdorph O (1982) Computed tomography in intracranial tumors. Springer, Berlin Heidelberg New York
Kingsley DPE, Kendall BE (1977) Dependent layering of contrast medium in cystic astrocytomas. Neuroradiology 14: 107–110
Kuschinski G, Lüllmann H (1972) Kurzes Lehrbuch der Pharmakologie. Thieme, Stuttgart New York
Kuwashima J, Fujitani B, Nakamura K, Kadokawa T, Yoshida K, Shimizu M (1976) Biochemical changes in unilateral brain injury in the rat: a possible role of free fatty acid accumulation. Brain Res 110: 547–557
Laster D, Moody D, Ball M (1978) Resolving intracerebral hematoma: alteration of the “ring-sign” with steroids. AJR 130: 935–939
Lililequist B, Wirell S (1978) Quantitative estimation of tumor volume in computer assisted tomography. J Comput Assist Tomogr 2: 300–302
Lokich J (1975) Decadron therapy. JAM A 234: 748–751
Maxwell RE, Long DM, French LA (1971) The effects of glucosteroids upon cold induced brain edemas. J Neurosurg 34: 477–487
Mealey J, Cheng TT, Schnaz GP (1971) Effects of dexamethasone and methyl-prednisolone on cell cultures of human glioblastomas. J Neurosurg 34: 324–334
Moeschlin S (1976) Therapiefibel der Inneren Medizin für Klinik und Praxis, 5. Aufl. Thieme, Stuttgart New York
Mutschler E (1975) Arzneimittelwirkungen 3. Aufl. Wissenschaftliche Verlagsgesellschaft, Stuttgart
Reulen HJ, Hadjidimos A, Hase U (1973) Steroids in the treatment of brain edema. In: Schürmann K, Brock M, Reulen HJ, Voth D (eds) Advances in neurosurgery, Vol. 1. Springer, Berlin Heidelberg New York
Reulen HJ, Hadjidimos A, Schürmann K (1972) The effect of dexamethasone on water and electrolyte content and on r-CBF in perifocal brain edema in man. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York
Sano K, Hatanaka H, Kamano S (1972) Steroids and the blood-brain barrier with special reference to astrocytic cells. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York
Shapiro WR, Posener JB (1974) Corticosteroid hormones. Effects in an experimental brain tumor. Arch Neurol 30: 217–221
Spatz M, Fujimoto T, Go G (1976) Transport studies in ischemic cerebral edema. In: Pappins H, Feindel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York
Weiss MH, Nulsen FE (1970) The effect of glucocorticoids on CSF flow in dogs. J Neurosurg 32: 452–458
Wilson CB, Barker M, Hoshino T, Oliver A, Downie R (1972) Steroid induced inhibition of growth in glial tumors: a kinetic analysis. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York
Zülch KJ (1979) Histological typing of tumors of the central nervous system. WHO, Geneva
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Müller, W., Kretzschmar, K. & Schicketanz, K.H. CT-analyses of cerebral tumors under steroid therapy. Neuroradiology 26, 293–298 (1984). https://doi.org/10.1007/BF00339773
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00339773