• Thirty-six patients brought to a hospital with symptoms of cerebral infarction were classified as to the severity of the condition and divided into two groups comparable as to severity, age, blood pressure, and other essential criteria. Both groups received the usual supportive care. The test group of 17 patients received, in addition, 300 mg. of cortisone and 3 gm. of potassium chloride daily with a low-salt diet. The cortisone was given in divided doses, and the dosage was reduced after the second day. The contra-test group of 19 patients received a placebo. There were 13 deaths in the cortisone and 10 in the placebo group. The difference, though small enough to have arisen by chance, discouraged further use of cortisone in this situation. The classification according to severity was found to have prognostic value, and an impressive number of patients were seen who could not be admitted to either group because their symptoms cleared up spontaneously within a few hours. Cortisone must not be used indiscriminately. Its unfavorable effects in this series of patients occurred despite observance of known contraindications. Emphasis in cases of cerebral infarction should be on general supportive treatment.
Dyken M, White PT. EVALUATION OF CORTISONE IN THE TREATMENT OF CEREBRAL INFARCTION. JAMA. 1956;162(17):1531–1534. doi:10.1001/jama.1956.02970340021007
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