{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:14:45Z","timestamp":1787170485074,"version":"build-2736575974"},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Cranial and spinal epidermoid cysts (ECs) are rare and surgical resection can be complicated by chemical meningitis. Here, we treated a patient undergoing surgical resection of an intramedullary spinal EC with prophylactic steroids to help prevent postoperative chemical meningitis. Notably, we found a paucity of evidence regarding the efficacy of steroids used for this purpose.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 44-year-old male presented with a rare intramedullary thoracic EC. He was given oral dexamethasone postoperatively and did not subsequently develop chemical meningitis. Here, we reviewed the current literature regarding the efficacy of steroid use for this purpose, utilizing multiple electronic databases (Ovid MEDLINE, Ovid EMBASE, and Scopus). We found only three studies (one case report, one case series, and a randomized controlled trial), that involved patients who received steroids. Of the 24 patients given prophylactic steroids, none developed fever or meningismus. One patient received 8 days of oral dexamethasone. Eleven patients received intraoperative hydrocortisone irrigation alone, while final 12 patients received intraoperative hydrocortisone irrigation plus a 3 week postoperative tapering course of oral steroids. Notably, all of the nine patients who did not receive any steroids developed postoperative fever, with 78% demonstrating meningismus.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Here is level II evidence that establishes the efficacy of prophylactic steroids utilized in patients undergoing surgery for ECs to prevent postoperative chemical meningitis. Nevertheless, there is still no current consensus regarding either the type of steroid utilized, or the route of administration.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_797_2020","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T03:25:41Z","timestamp":1609212341000},"page":"472","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Do prophylactic steroids prevent chemical meningitis in surgery for epidermoid cysts? Case report and literature review"],"prefix":"10.25259","volume":"11","author":[{"given":"Renata","family":"Ganko","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Macquarie University Hospital, Macquarie Park, New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Douglas Hanly Moir Pathology (Sonic Healthcare), New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Magnussen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Simons","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Myint","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Douglas Hanly Moir Pathology (Sonic Healthcare), New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazih","family":"Assaad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Macquarie University Hospital, Macquarie Park, New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"10.25259\/SNI_797_2020\/ref-1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.14245\/ns.1836014.007","article-title":"Spinal epidermoid tumors: Case report and review of the literature","volume":"15","author":"Beechar","year":"2018","journal-title":"Neurospine"},{"key":"10.25259\/SNI_797_2020\/ref-2","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3171\/jns.1985.62.2.0214","article-title":"Epidermoid cysts of the posterior fossa","volume":"62","author":"Berger","year":"1985","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_797_2020\/ref-3","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/S0140-6736(67)90946-4","article-title":"Corticosteroids in aseptic meningitis","volume":"290","author":"Cantu","year":"1967","journal-title":"Lancet"},{"key":"10.25259\/SNI_797_2020\/ref-4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12957-017-1186-4","article-title":"A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: Case report and review of the literature","volume":"15","author":"Funao","year":"2017","journal-title":"World J Surg Oncol"},{"key":"10.25259\/SNI_797_2020\/ref-5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.neuchi.2017.01.004","article-title":"Intramedullary epidermoid cysts in adults: Case report and updated literature review","volume":"63","author":"Graillon","year":"2017","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_797_2020\/ref-6","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/00024720-200304000-00012","article-title":"Spinal epidermoid tumors: Novel approach to aseptic meningitis","volume":"16","author":"Kapoor","year":"2003","journal-title":"J Spinal Disord Tech"},{"key":"10.25259\/SNI_797_2020\/ref-7","article-title":"National Health and Medical Research Council (NHMRC): A Guide to the Development","volume-title":"Implementation and Evaluation of Clinical Practice Guideline","year":"1999"},{"key":"10.25259\/SNI_797_2020\/ref-8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/MOO.0b013e328309505c","article-title":"Assessment and 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