Cerebral Salt Wasting Syndrome Caused by Severe Traumatic Brain Injury in a Pediatric Patient and Review of the Literature. (22nd October 2021)

• Record Type: Journal Article
• Authors: Daghmouri, Mohamed Aziz; Ouesleti, Maroua; Touati, Mohamed Amine; Faten, Olfa; Zakhama, Sameh; Rebai, Lotfi
• Other Names: Yegneswaran Balaji Academic Editor.
• Is Part Of: Case reports in critical care. Volume 2021(2021)
• Publication Date: 2021-10-22
• Subjects: Critical care medicine -- Periodicals; Emergency medicine -- Periodicals; Medical emergencies -- Periodicals; 616.02805
• DOI: 10.1155/2021/6679279
• Languages: English
• ISSNs: 2090-6420

Abstract

Abstract : Background . Following acute traumatic brain injury, cerebral salt wasting (CSW) syndrome is considered as an important cause of hyponatremia apart from syndrome of inappropriate antidiuretic hormone. Differentiation between the two syndromes is crucial for the initiation of an adequate treatment. Case Presentation. We report a 15-year-old female adolescent, admitted to intensive care for acute severe traumatic brain injury. During his hospitalization, she developed a hyponatremia with an increase of urine output and hypovolemia. So, the most probable diagnosis was CSW. Initially, she was treated by hypertonic saline and volume expansion. However, his sodium level continued to fall despite infusion of hypertonic saline. That is why fludrocortisone was introduced initially at 50 μ g/day then increased to 150 μ g/day. Fludrocortisone was continued for the next months. Serum sodium level was 138 mmol/L after one month of treatment. Conclusion . Hyponatremia may occur after severe traumatic brain injury that is why an adequate treatment initiated on time is necessary in order to reduce morbidity and mortality.