Dexamethasone in Primary Supratentorial Intracerebral Hemorrhage

To the Editor: I take issue with the suggestion by Poungvarin et al. (May 14 issue)* that dexamethasone is not helpful in intracerebral hemorrhage and is possibly harmful. The authors' own results suggest otherwise. I agree that the level of consciousness is the most important element of the Glasgow Coma Scale, but the scale also includes motor and eye-opening components. The group treated with dexamethasone had hematomas that were an average of 20 percent larger than those in the controls. This could have biased neurologic assignment because of the existence of differing levels of consciousness within the same coma-score group.