In this episode, I’ll discuss the loading dose of dexamethasone for vasogenic edema.
Vasogenic cerebral edema is associated with primary or metastatic brain tumors and, depending on the severity of symptoms, may present as an emergency.
Dexamethasone is the corticosteroid of choice to treat vasogenic cerebral edema as it’s low mineralocorticoid effects mean it will not promote fluid retention like other steroids might.
Because the effects of dexamethasone to reduce edema are dose-dependent, the loading dose used to treat vasogenic edema is dictated by the severity of symptoms.
Severe symptoms of vasogenic edema include:
1. Focal neurologic deficit
2. Nausea and/or vomiting
3. Severe headache
4. Seizure
Patients with severe vasogenic edema get a 10 mg IV loading dose of dexamethasone.
If vasogenic edema is suspected but symptoms are judged to be mild, a loading dose is typically not used.
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