A rare cause of refractory hyponatremia after traumatic brain injury: Acute post-traumatic hypopituitarism due to pituitary stalk transection

Ergül A. B., Ozcan A., Bas V. N., Aslaner H., Kurtoglu S., Torun Y. A., ...Daha Fazla

JOURNAL OF ACUTE MEDICINE, cilt.6, sa.4, ss.102-104, 2016 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 6 Sayı: 4
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1016/j.jacme.2016.09.001
  • Dergi Adı: JOURNAL OF ACUTE MEDICINE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.102-104
  • Erciyes Üniversitesi Adresli: Evet

Özet

We report a 1.5-year-old boy with refractory hyponatremia related to pituitary stalk transection, which is a rare cause of hyponatremia after traumatic brain injury. The patient was referred to our hospital with a hyponatremic convulsion 6 days after head trauma. The patient's laboratory findings were compatible with syndrome of inappropriate antidiuretic hormone secretion (SIADH). The hyponatremic convulsion was treated with a hypertonic saline infusion and the SIADH was treated with fluid restriction, but serum levels of sodium did not increase. Acute post-traumatic hypopituitarism was diagnosed based on basal pituitary function tests and imaging. Hypophysis magnetic resonance imaging showed pituitary stalk transection. He was diagnosed with post-traumatic hypopituitarism due to pituitary stalk transection and given L-thyroxine and hydrocortisone. After the treatment, sodium and thyroid hormone levels returned to normal. Acute post-traumatic hypopituitarism is a potentially important cause of hyponatremia after traumatic brain injury, and can be mis-diagnosed as SIADH. Copyright (C) 2016, Taiwan Society of Emergency Medicine. Published by Elsevier Taiwan LLC.