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Published on: July 5, 2011
Refractory hyponatremia solved through early cranioplasty after decompressive hemicraniectomy in a traumatic brain
Maria Teresa Alvarado-Torres1, Harold España Arrieta2, Juan Sebastian Davidson1
1Neurosurgery Service, Hospital Serena del Mar, Cartagena, Colombia.
Background:
Hyponatremia is a frequently encountered electrolyte disorder in neurocritical care patients, often associated with various types of brain injuries such as hemorrhages, ischemic events, tumors, infections, surgical procedures, and traumatic brain injury (TBI), among others.
Case Presentation:
Herein, we present a case study of a patient with severe TBI who underwent decompressive craniectomy and subsequently developed persistent hyponatremia during the Intensive Care Unit (ICU) stay. Recognizing the crucial distinction between the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) and Cerebral Salt Wasting (CSW) syndrome is imperative, given the distinct treatment approaches required for each condition. The patient underwent ultra-early cranioplasty, which resulted in the subsequent resolution of hyponatremia and improvement in clinical status.
Conclusion:
We provide a comprehensive review of the management of hyponatremia in neurocritical patients, underscoring the efficacy of early cranioplasty as a therapeutic intervention.
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