Abstract
Craniopharyngioma is associated with a wide and interesting variety of sodium states both by itself and following surgical resection. These are often challenging to diagnose, especially given their dynamic nature during the perioperative course. We present the case of a boy with craniopharyngioma who had hyponatremia due to cerebral salt wasting preoperatively, developed diabetes insipidus (DI) intraoperatively and proceeded to develop hypernatremia with adipsic DI.
Conclusion: Cerebral salt wasting is a rare presenting feature of craniopharyngioma. Postoperative DI can be associated with thirst abnormalities including adipsia due to hypothalamic damage; careful monitoring and a high index of suspicion are required for its detection. Adipsic DI is a difficult condition to manage; hence a conservative surgical approach is suggested.
References
1. Yee AH, Burns JD, Wijdicks EF. Cerebral salt wasting: pathophysiology, diagnosis, and treatment. Neurosurg Clin N Am 2010;21:339–52.10.1016/j.nec.2009.10.011Search in Google Scholar
2. Segura Matute S, Balaguer Gargallo M, Cambra Lasaosa FJ, Zambudio Sert S, Martín Rodrigo JM, et al. Fluid and electrolyte disorders following surgery for brain tumors. An Pediatr 2007;67:225–30.10.1016/S1695-4033(07)70611-2Search in Google Scholar
3. Santra S, Chakraborty J, Das B. Cerebral salt wasting syndrome in craniopharyngioma. Indian J Anaesth 2013;57:404–5.10.4103/0019-5049.118533Search in Google Scholar PubMed PubMed Central
4. Lin JJ, Lin KL, Hsia SH, Wu CT, Wang HS. Combined central diabetes insipidus and cerebral salt wasting syndrome in children. Pediatr Neurol 2009;40:84–7.10.1016/j.pediatrneurol.2008.09.010Search in Google Scholar PubMed
5. Pratheesh R, Swallow DM, Rajaratnam S, Jacob KS, Chacko G, et al. Incidence, predictors and early post-operative course of diabetes insipidus in paediatric craniopharyngioma: a comparison with adults. Childs Nerv Syst 2013; 29:941–9.10.1007/s00381-013-2041-8Search in Google Scholar PubMed
6. Smith D, Finucane F, Phillips J, Baylis PH, Finucane J, et al. Abnormal regulation of thirst and vasopressin secretion following surgery for craniopharyngioma. Clin Endocrinol (Oxf) 2004;61:273–9.10.1111/j.1365-2265.2004.02086.xSearch in Google Scholar PubMed
©2015 by De Gruyter