Case Report

Hypernatremia and central Diabetes Insipidus following Neurosurgical procedure of Trauma

Awad Magbri*, Eussera El-Magbri and Seth Hershit

Published: 12 June, 2017 | Volume 1 - Issue 1 | Pages: 005-008

The greater risk of hypernatremia in patients over 65 years old are associated with impaired mental status and physical disability which may result in impaired sensation to thirst, impaired ability to express thirst, and/or decrease access to water [1,2]. Normally, anti-diuretic hormone (ADH, also known as arginine-vasopressin, AVP) is secreted in response to 1-2% increase in osmolality which stimulate thirst, as do hypovolemia and hypotension.

Read Full Article HTML DOI: 10.29328/journal.hjpcr.1001002 Cite this Article Read Full Article PDF


Hypernatremia; Central diabetes insipidus; Pituitary adenoma; Traumatic brain injury; Urine and Plasma osmolality; dDAVP; Triphasic or Adepsic DI


  1. Palevsky PM. Hypernatremia. Semin Nephrol. 1998; 18: 20-30. Ref.: https://goo.gl/qgUvGE
  2. Hoefer D, Ruttmann-Ulmer E, Smiths JM, Devries E, Antretter H, et al. Donor hypo-and hypernatremia are predictors for increased 1-year mortality after cardiac transplantation. Transpl Int. 2010; 23: 589-593. Ref.: https://goo.gl/9Eh97O
  3. Lin JJ, Lin KL, Hsia SH, Wu CT, Wang HS, et al. Combined central diabetes insipidus and cerebral salt wasting syndrome in children. Pediatr Neurol. 2009; 40: 84-87. Ref.: https://goo.gl/gJxIgv
  4. Rose BD, Post TW. Clinical physiology of acid-base and electrolyte disorders, 5th ed, McGraw-Hill. 2001: 751. Ref.: https://goo.gl/4D1Vmk
  5. Kimmel DW, O’Neill BP. Systemic cancer presenting as diabetes insipidus. Clinical and radiological features of 11 patients with a review of metastatic-induced diabetes insipidus. Cancer. 1983; 52: 2355-2358. Ref.: https://goo.gl/k8qCb0
  6. Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, et al. Central diabetes insipidus in children and young adults. N Engl J Med. 2000; 343: 998-1007. Ref.: https://goo.gl/zWlTxP
  7. Grois N, Fahrner B, Arceci RJ, Henter JI, McClain K, et al. Central nervous system disease in Langerhans cell histiocytosis. J Pediatric. 2010; 156: 873-881. Ref.: https://goo.gl/wRPoBK
  8. Werny D, Elfers C, Perez FA, Pihoker C, Roth CL, et al. Pediatric central diabetes insipidus: Brain malformations are common and few patients have idiopathic disease. J Clin Endocrinol Metab. 2015; 100: 3074-3080. Ref.: https://goo.gl/uqxbcH
  9. Brewster UC, Hayslett JP. Diabetes insipidus in the third trimester of pregnancy. Obstet Gynecol. 2005; 105: 1173-1176. Ref.: https://goo.gl/bNzs2w
  10. Lindheimer MD. Polyuria and pregnancy: its cause, its danger. Obstet Gynecol. 2005; 105: 1171-1172. Ref.: https://goo.gl/ikaGGs
  11. Seckl J, Dunger D. Postoperative diabetes insipidus. BMJ. 1989; 298: 2-3. Ref.: https://goo.gl/A5ZgkU
  12. Nemergut EC, Zuo Z, Jane JA Jr, Laws ER Jr. Predictors of diabetes insipidus after trans-sphenoidal surgery: a review of 881 patients. J Neurosurg. 2005; 103: 448-454. Ref.: https://goo.gl/7LU35X
  13. Ghirardello S, Hopper N, Albanese A, Maghnie M. Diabetes insipidus in craniopharyngeoma: postoperative management of water and electrolyte disorders. J Pediatr Endocrinol Metab. 2006; 19: 413-421. Ref.: https://goo.gl/bLYq92
  14. Hadjizacharia P, Beale EO, Inaba K, Chan LS, Demetriades D. Acute diabetes insipidus in severe head injury: a prospective study. J Am Coll Surg. 2008; 207: 477-484. Ref.: https://goo.gl/p8agfR
  15. Seckl JR, Dunger DB, Bevan JS, Nakasu Y, Chowdrey C, et al. Vasopressin antagonist in early postoperative diabetes insipidus. Lancet. 1990; 335: 1353-1356. Ref.: https://goo.gl/VPJ4Ov
  16. Sigounas DG, Sharpless JL, Cheng DM, Johnson TG, Senior BA, et al. Predictors and incidence of central diabetes insipidus after endoscopic pituitary surgery. Neurosurgery. 2008; 62: 71-78. Ref.: https://goo.gl/k4x1eD
  17. Hensen J, Henig A, Fahlbusch R, Martin Meyer, Markus Boehnert, et al. Prevalence, predictors, and patterns of postoperative polyuria and hyponatremia in the immediate course after trans-sphenoidal surgery for pituitary adenomas. Cli Endocrinol. 1999; 50: 431-439. Ref.: https://goo.gl/bpPs01
  18. Hoorn EJ, Ziestse R. Water balance disorders after neurosurgery: the triphasic response revisited. NDT Plus. 2010; 3: 42-44. Ref.: https://goo.gl/1m0pA6
  19. Loh JA, Verbalis JG. Diabetes insipidus as a complication after pituitary surgery. Nat Clin Pract Endocrinol Metab. 2007; 3: 489-494. Ref.: https://goo.gl/xUq3Cu
  20. Lipsett MB, Maclean JP, West CD, Li MC, Pearson OH. An analysis of the polyuria induced by hypophysectomy in man. J Clin Endocrinol Metab 1956; 16: 183-195. Ref.: https://goo.gl/mu8tfE
  21. Crowley RK, Sherlock M, Agha A, Smith D, Thompson CJ. Clinical insights into adepsic diabetes insipidus: A large case series. Clin Endocrinol. 2007; 66: 475-482. Ref.: https://goo.gl/fQZqhy
  22. Mizobata Y, Yokota J, Matsuoka T, Horikawa H, Nakai K, et al. Volume supplementation with iso-sodium solution prevents hypernatremia after head injury. J Trauma. 2001; 50: 871-877. Ref.: https://goo.gl/XkSqtI
  23. Bajwa SJ, Kulshrestha A. Renal endocrine manifestations during polytrauma: A cause of concern for the anesthesiologist. Indian J Endocrinol Metab. 2012; 16: 252-257. Ref.: https://goo.gl/y0bjuU
  24. Tisdall M, Crocker M, Watkiss J, Smith M. Disturbances of sodium in critically ill neurologic patients: A clinical review. J Neurosurg Anesthesiol. 2006; 18: 57-63. Ref.: https://goo.gl/Sco7Y7

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