Cerebral salt wasting following pituitary surgery for macroadenoma.
- Author:
Tak Ho SONG
1
;
Sung Soo LA
;
Chang Seok BANG
;
Sang Seok LEE
;
Ha Yan KANG
;
Hee Jin KIM
;
Sang Koo LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Dankook University, Cheonan, Korea. hjinkim@dankook.ac.kr
- Publication Type:Case Report
- Keywords:
Hyponatremia;
Cerebral salt wasting;
Syndrome of inappropriate secretion of antidiuretic hormone;
Pituitary adenoma
- MeSH:
Aged;
Central Nervous System;
Dehydration;
Homeostasis;
Humans;
Hyponatremia;
Inappropriate ADH Syndrome;
Natriuresis;
Nervous System Diseases;
Pituitary Neoplasms;
Polyuria;
Sodium
- From:Korean Journal of Medicine
2007;73(4):432-437
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The central nervous system (CNS) has important roles in the regulation of sodium and water homeostasis, so the risk of hyponatremia is increased for patients with neurological disorders. Cerebral salt wasting (CSW) is a syndrome that is characterized by hyponatremia and extracellular volume contraction, and these problems are caused by natriuresis and the concomitant polyuria in patient with intracranial disease. It is critical to differentiate CSW from syndrome of inappropriate secretion of antidiuretic hormone (SIADH) for patients with hyponatremia and after they experience cerebral insults. This is because fluid restriction is the treatment of choice for SIADH and administration of isotonic or hypertonic saline is important for treating CSW. We report here on a case of CSW following trassphenoidal surgery for pituitary tumor in a 67-year-old man with nonfunctioning pituitary macroadenoma. Hyposmotic hyponatremia, increased urine output and signs of dehydration developed postoperatively, and the patient was managed by water and salt supplementation.
