Citation

Kächele M, van Erp R, Schmid K, Bettac L, Wagner M, Schröppel B. Internist 2019; ePub(ePub): ePub.

Vernacular Title

Symptomatische Hyponatriämie bei einer 43-Jährigen nach Skiunfall mit Kopftrauma.

Affiliation

Klinik für Innere Medizin I - Sektion Nephrologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00108-019-00697-9

PMID

31673730

Abstract

This article reports the case of a 43-year-old woman who presented to the emergency room with headache and paresthesia after a fall on the head while skiing. She had clinical signs of volume depletion and blood test showed severe hyponatremia. Cerebral imaging was unremarkable. The diagnosis of cerebral salt-wasting syndrome (CSWS) was made, which is defined by the presence of extracellular volume depletion due to a tubular defect in renal sodium transport in patients with normal adrenal and thyroid function. The disease is mostly secondary to a neurological disease or head trauma. The patient rapidly improved after volume therapy and treatment with mineralocorticoids. The differentiation of CSWS from the syndrome of inappropriate antidiuretic hormone (SIADH) secretion can be challenging but the distinction is important because treatment options are very different.

Language: de

Keywords

Cerebral salt wasting; Electrolytes; Fluid therapy; Hypophosphatemia; Syndrome of inappropriate antidiuretic hormone secretion