Keywords
Neurological Manifestations
Syndrome of Inappropriate ADH (SIADH) Secretion
Craniocerebral Trauma
Water-Electrolyte Imbalance
Case Reports
How to Cite
Abstract
Introduction: Cerebral salt wasting syndrome is characterized by a loss of sodium at the renal level causing hypovolemia and hyponatremia, basing its management on water and sodium replacement.
Purpose: To present a case of a patient with cerebral salt wasting syndrome after a cranioencephalic trauma.
Case presentation: A 45-year-old man who had suffered one month before a cranioencephalic trauma and abdominal trauma with urinary tract injury, carrying a cystostomy catheter, consulted for the presence of inflammatory signs at the catheter insertion site and fever. During his hospitalization, neurological deficit and hyponatremia were noted. After the studies performed, it was considered that she had a cerebral salt wasting syndrome. Treatment was with water replacement and sodium chloride supplementation in the diet. The patient was discharged with clinical improvement. Four weeks later he had resolution of neurological symptoms and reached normal serum sodium levels.
Discussion and conclusion: We have documented a case of cerebral salt wasting syndrome following cranioencephalic trauma: unlike the syndrome of inadequate ADH secretion, the latter is usually transient. For diagnosis, the presence of slightly dry mucous membranes, thirst, increased urine density, high urine sodium and high uric acid excreted fraction were helpful for differentiation. Persistence of an excreted uric acid fraction after correction of hyponatremia may point to cerebral salt wasting syndrome.
References
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