Steroids may worsen head injury

Steroids are widely used to treat people who suffer severe head injury, but recent research indicates that the therapy does more harm than good. Patients with head injury who are treated with methylprednisolone have a significantly increased risk of dying within the following two weeks compared with untreated patients. The researchers at the London School of Hygiene and Tropical Medicine conducted the CRASH (corticosteroid randomisation after significant head injury) trial. The aim of the CRASH study was to enroll 20,000 adults within 8 hours of head injury, and treat them randomly with a 48-hour infusion of either methylprednisolone or an inactive placebo. After 10,000 patients had been enrolled, recruitment to the trial was ended because unmasked results showed a 21 percent mortality rate within two weeks among those treated with methylprednisolone, versus 18 percent among those allocated to placebo. The study refuted a mortality benefit from corticosteroids in head injury. The above findings can protect many patients from any increased risk of death associated with these drugs.

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