The entity of nonketotic liyperglycemic´ hyperosmolar coma´.(NHHC) - was described as a severe and often fatal complication in 1957 (Sament and Schwartz), but since the it : has been observed As a complication of various primary diseases, both ´´in diabetic and non diabetic patients.
Various predisposing factors in its development include administration of prolonged mannitol, steroid, Dilantin, hyperosmolar tube feeding, dehydration, and diabetes. Combination of these factors are frequently used in the management of patients with neurological disorders and cerebral edema, consequently, a higher prevalence of NHHC might be expected in these patients.
We have recently experienced a case of typical NHHC, in whom treated by mannitol, steroid, and Dilantin after emergency craniotomy for head injury.
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