TITLE:
Prolonged coexistent central diabetes insipidus and cerebral salt wasting syndrome following neurosurgery
AUTHORS:
D. López de Lara, B. Joyanes, A. Llaneza, O. Pérez, B. Llorente, I. Runkle
KEYWORDS:
Electrolyte Disorder; Diabetes Insipidus; Cerebral Salt Wasting Syndrome; Neurosurgery
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.3 No.2,
June
7,
2013
ABSTRACT: The coexistence of different water homeostasis abnormalities following neurosurgery represents a diagnostic and therapeutic challenge for intensive care units. This paper reports the case of a 13 year-old boy who underwent surgery for a suprasellar tumour and, immediately after surgery, developed a cerebral abscess, persistent diabetes insipidus (DI) as well as cerebral salt wasting syndrome (CSWS). The early onset of CSWS following DI has been associated with a poor prognosis and increased mortality. In cases in which these abnormalities coexist, the increased polyuria secondary to the rise in natriuresis associated with CSWS might be erroneously interpreted as a sign of poor control of the DI, thereby leading to therapeutic mistakes. Treatment basically consists of restoring electrolytes and the joint administration of desmopressin and fludrocortisone.