Acute symptomatic hyponatremia and cerebral salt wasting after head injury: an important clinical entity

Details

Serval ID
serval:BIB_A7E46237DD69
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Acute symptomatic hyponatremia and cerebral salt wasting after head injury: an important clinical entity
Journal
Journal of Pediatric Surgery
Author(s)
Donati-Genet  P. C., Dubuis  J. M., Girardin  E., Rimensberger  P. C.
ISSN
0022-3468
Publication state
Published
Issued date
07/2001
Peer-reviewed
Oui
Volume
36
Number
7
Pages
1094-7
Notes
Case Reports
Journal Article --- Old month value: Jul
Abstract
Hyponatremia is a well known complication of traumatic and nontraumatic cerebral injury, often related to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Nonetheless, it also can be associated with a different entity, the syndrome of cerebral salt wasting (CSW). The authors report the case of a 4.5-year-old boy presenting with major head injury who at day 6 after admission had generalized tonic-clonic seizures caused by severe acute hyponatremia (serum sodium level, 119 mmol/L) and signs of dehydration. Despite initial isotonic rehydration, hyponatremia persisted because of excessive renal salt losses and concomitant enormous water losses, necessitating increasing amounts of sodium, up to 160 mmol/kg/d, and large amounts of intravenous fluids, up to 27 L/d. Highly increased levels of atrial natriuretic peptide (ANP) confirmed the diagnosis of CSW. The occurrence of a CSW has to be recognized early in the clinical course for adequate treatment and remains one of the important differential diagnosis of SIADH in hyponatremic states in patients with cerebral disorders, especially after head injury.
Keywords
Acute Disease Adrenocorticotropic Hormone/blood Aldosterone/blood Atrial Natriuretic Factor/blood Brain/*metabolism Brain Injuries/*complications/metabolism Child, Preschool Humans Hydrocortisone/blood Hyponatremia/blood/*etiology/therapy Male Sodium/*metabolism Vasopressins/blood
Pubmed
Web of science
Create date
15/01/2008 14:28
Last modification date
20/08/2019 15:12
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