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, ss.102-104, 2016 (ESCI İndekslerine Giren Dergi) identifier identifier

  • Cilt numarası: 6 Konu: 4
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1016/j.jacme.2016.09.001
  • Dergi Adı: JOURNAL OF ACUTE MEDICINE
  • Sayfa Sayıları: ss.102-104

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.