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KMID : 0882420070730040432
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Korean Journal of Medicine
2007 Volume.73 No. 4 p.432 ~ p.437
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Cerebral salt wasting following pituitary surgery for macroadenoma
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Song Tak-Ho
La Sung-Soo
Bang Chang-Seok
Lee Sang-Seok
Kang Ha-Yan
Kim Hee-Jin
Lee Sang-Koo
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Abstract
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The central nervous system (CNS) has important roles in the regulation of sodium and water homeostasis, so the risk
of hyponatremia is increased for patients with neurological disorders. Cerebral salt wasting (CSW) is a syndrome that
is characterized by hyponatremia and extracellular volume contraction, and these problems are caused by natriuresis and
the concomitant polyuria in patient with intracranial disease. It is critical to differentiate CSW from syndrome of
inappropriate secretion of antidiuretic hormone (SIADH) for patients with hyponatremia and after they experience
cerebral insults. This is because fluid restriction is the treatment of choice for SIADH and administration of isotonic or
hypertonic saline is important for treating CSW. We report here on a case of CSW following trassphenoidal surgery for
pituitary tumor in a 67-year-old man with nonfunctioning pituitary macroadenoma. Hyposmotic hyponatremia, increased
urine output and signs of dehydration developed postoperatively, and the patient was managed by water and salt
supplementation
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KEYWORD
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Hyponatremia, Cerebral salt wasting, Syndrome of inappropriate secretion of antidiuretic hormone, Pituitary adenoma
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