Steroid-induced avascular necrosis of bone in neurosurgical patients

After administration of short-term high-dose prednisolone in two patients with brain tumors, avascular necrosis of the femoral head was noted 7 and 15 months later, respectively. Both patients required replacement of the femoral heads. Despite the extensive use of steroid therapy in neurosurgical practices, reports of avascular necrosis of bone have been exceedingly sparse. This pathological condition evolves several months later, and has received scant attention in the neurosurgical literature. Particularly in patients with hemiparesis, the hip joints on the affected side are thought to suffer from avascular necrosis more frequently. For this reason, sufficiently long-term observation for the early detection of this complication is necessary in patients treated with steroids.