J Korean Child Neurol Soc.  2002 Nov;10(2):333-337.

Cerebral Salt Wasting Syndrome Associated with Meningitis in a Child

• Kim SH
• Jang HO
• Kim DW
• Jo HS
• Moon JS
• Jang GY
• Nam SY
• Lee CG

Abstract

Hyponatremia is commonly seen in those patients with central nervous system injury associated with infection or trauma. And decreasing intracranial pressure through restriction of maintenance fluid and salt is practiced as a routine therapeutic measure in the early stages of meningitis to prevent or ameliorate the syndrome of inappropriate secretion of antidiuretic hormone(SIADH). However, lots of patient do not show the typical symptoms of SIADH, instead they are dehydrated, have low plasma volume, increased urine sodium concentration and increased net sodium loss, which are the symptoms of cerebral salt wasting syndrome(CSW). Recent reports have prompted a reconsideration of CSW distinct from SIADH and moreover CSW has more proportion of hyponatremia associated with acute brain insult. CSW involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. While fluid restriction is the treatment of choice in SIADH, the treatment of CSW consists of vigorous sodium and volume replacement. And by correcting hyponatremic state as soon as possible, we can reduce mortality rate and improve neurologic sequelae. We report a case of CSW which was treated by replacement of vigorous sodium and volume replacement.

Keyword

Cerebral salt wasting syndrome; Hyponatremia; Meningitis; Syndrome of inappropriate secretion of antidiuretic hormone

MeSH Terms

Brain
Central Nervous System
Child*
Humans
Hyponatremia
Inappropriate ADH Syndrome
Intracranial Pressure
Meningitis*
Mortality
Plasma Volume
Sodium
Wasting Syndrome*
Sodium