Adults with TBI who fulfill the following inclusión criteria are eligible:

Patients who have suffered TBI and have one or more cerebral contusions with visible pericontusional edema in the computed tomography (CT) scan.

Patients with brain contusions in whom non-sugical treatment has been selected initially.

Age 18 or over and under 85.

Signing of informed consent by the patient or by his legal representative.

The fundamental eligibility criterion is the responsible clinicians “uncertainty” as to whether or not to use dexamethasone in a particular patient with TBI. This pragmatic approach will allow us to see whether the intervention improves patient outcomes under real-life conditions.

The exclusion criteria are the following:

Patients with TBI and brain contusions who have required surgery to evacuate the cerebral contusion before randomization.

Patients with TBI who have required a craniotomy before randomization for any other reason: evacuation of subdural, epidural hematoma or depressed skull fracture.

Patients with an extracranial Injury Severity Score greater than 18 points.

Patients in whom the use of corticosteroids is contraindicated.

Patients who take oral corticosteroids chronically.

Patients included in another clinical trial.

Known intolerance or hypersensitivity to dexamethasone.

Patients with allergy or intolerance to the following excipients contained in dexamethasone/placebo capsules: lactose, corn starch or microcrystalline cellulose.

Patients with a history of psychotic disorders.

Patients with inability to take medication orally due to swallowing problems in which it is not indicated to place a nasogastric tube.

Pregnant or breastfeeding patients.

Patients in a GCS 3 points situation with bilateral fixed dilated pupils.

Patients with associated spinal cord injuries.

Patient with any systemic condition that contraindicates the use of corticosteroids.

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