What is your approach for tapering steroids after craniotomy for tumor resection?

• Benign disease (i.e., meningioma) without significant edema - taper dexamethasone off over 5 days.
• Benign disease (i.e., meningioma) with edema - taper dexamethasone off 7-10 days.
• Malignant low-grade glioma - taper dexamethasone off over 7-10 days.
• Malignant high-grade glioma - taper dexamethasone...

Steroid tapers are an art, not a science. I think goal setting for the length of the taper should depend a bit on the degree of edema (similarly to what Dr. @Dr. First Last answered), but the actual taper should be symptom-driven. I typically find that symptoms emerge or change 1-2 days after a decr...