Impact of Steroid (Dexamethasone) Therapy on Clinical Outcomes and Functional Recovery in Patients with Acute Stroke

Background: Stroke is a leading cause of death and long-term disability worldwide, particularly in developing countries.Inflammation and cerebral edema contribute to secondary brain injury following acute stroke, and corticosteroids are often used to reduce these effects.However, their role in improving clinical outcomes and functional recovery remains controversial.This study aimed to evaluate the impact of steroid therapy on clinical outcomes and functional recovery among patients with acute stroke.Methods: This prospective observational study was conducted in the Department of Neurology, National Institute of Neuro Sciences and Hospital, Dhaka, Bangladesh, from October 2023 to September 2025.A total of 300 adult patients with acute ischemic or hemorrhagic stroke were enrolled consecutively.Sociodemographic data, clinical characteristics, stroke severity (GCS and mRS), steroid therapy details, and hospital stay were recorded.Results: Most patients were aged 61-70 years (28.0%), and females predominated (59.3%).Intracerebral hemorrhage was the commonest stroke subtype (55.3%).Severe disability at admission (mRS 5) was observed in 79.7% of patients.Steroids were administered to 60.0% of cases, mainly for 1-5 days.Overall, 68.7% were discharged alive, while 31.3%died.Favorable functional outcome (mRS ≤2) was achieved in 7.3% at discharge and 17.0% at follow-up.Complications occurred in 47.0% of patients, most commonly electrolyte imbalance (23.7%).Conclusion: There is no survival benefit or reduction of morbidity in hospitalized or follow-up cohorts of steroid (dexamethasone) therapy patients.Early intervention and evidence-based management strategies are essential to optimize outcomes.