Severe hypernatremia in an extremely low birth weight infant with subsequent normal neurological development

Severe preterm hypernatremia is a life-threatening electrolyte disorder which mainly causes neurological complications such as brain edema, intracranial hemorrhages, hemorrhagic infarctions and thromboses. We report the case of an extremely low birth weight infant (520 g, 24+6 weeks of gestation) with severe hypernatremia of 199 mmol/l due to a failure in the preparation of an infusion on the 7th day of life. The infant subsequently showed no signs of central nervous system complications and no neurological symptoms due to this mishap so far. MRI scan performed after 4 months showed no evidence of cerebral complications including white matter injury. Even severe hypernatremia might not inevitably lead to central nervous system dysfunction and seizures in extremely low birth weight infants.