Hyperglycaemia and cerebral oedema in a patient with a meningioma receiving dexamethasone

Summary Dexamethasone is prescribed routinely to reduce cerebral oedema in neurosurgical patients undergoing craniotomy for tumour and is used increasingly as an anti-emetic. Dexamethasone, however, has been shown to cause hyperglycaemia. We describe a case of hyperglycaemic crisis, cerebral oedema and death secondary to dexamethasone in a patient with a frontal meningioma. We highlight the risks of peri-operative dexamethasone and discuss the diagnosis, treatment and complications of hyperglycaemic crises and cerebral oedema.