Cerebral Salt Wasting Syndrome following Brain Injury in Three Pediatric Patients: Suggestions for Rapid Diagnosis and TherapyBerkenbosch J.W. · Lentz C.W. · Jimenez D.F. · Tobias J.D.
Departments of aChild Health, bSurgery and cAnesthesiology, Divisions of dPediatric Critical Care/Pediatric Anesthesiology and ePediatric Neurosurgery, The University of Missouri-Columbia, Columbia, Mo., USA
The association between hyponatremia and intracranial pathology has been well described. When accompanied by natriuresis, hyponatremia has most commonly been attributed to inappropriate secretion of antidiuretic hormone. However, there is growing evidence to suggest that many of these patients may actually have cerebrally mediated salt losses, a disorder referred to as the cerebral salt wasting syndrome (CSWS). While this syndrome has been reasonably well described in adults, data regarding CSWS in pediatric-aged patients remains sparse. Since fluid management of these disorders is different, it is important that the clinician be able to rapidly differentiate between them. We report three cases of CSWS in acutely brain-injured children and comment on the role that early quantitation of urine volume and urine sodium concentration had in rapidly establishing the correct diagnosis.
John W. Berkenbosch, MD
Assistant Professor, Child Health, Pediatric Critical Care
The University of Missouri, Department of Child Health
One Hospital Drive, Columbia, MO 65212 (USA)
Tel. +1 573 882 6544, Fax +1 573 882 2742, E-Mail email@example.com
Received: Received: September 19, 2001
Accepted: November 27, 2001
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 18
Founded 1985 by E.B. Hendrick and D.H. Reigel; Editor-in-Chief 1992–1996: F.J. Epstein
Official Journal of the American Society of Pediatric Neurosurgeons (ASPN)
Vol. 36, No. 2, Year 2002 (Cover Date: February 2002)
Journal Editor: D.G. McLone, Chicago, Ill.
ISSN: 1016–2291 (print), 1423–0305 (Online)
For additional information: http://www.karger.com/journals/pne