Ann Clin Neurophysiol.  2022;24(1):30-34. 10.14253/acn.2022.24.1.30.

Cerebral salt wasting syndrome caused by external lumbar drainage in a patient with chronic hydrocephalus

Affiliations
  • 1Department of Rehabilitation Medicine, Gil Medical Center, Incheon, Korea

Abstract

In cases of hyponatremia induced by brain damage, it is important to distinguish between the syndrome of inappropriate anti-diuretic hormone secretion (SIADH) and cerebral salt wasting syndrome. A ventriculoperitoneal (VP) shunt is the standard treatment for hydrocephalus, and external lumbar drainage (ELD) is an option to evaluate the effect of a VP shunt. However, ELD has potential complications, such as subarachnoid hemorrhage, meningitis, and rarely hyponatremia. Therefore, we report a case of a patient with cerebral salt-wasting syndrome resulting from ELD to treat normal-pressure hydrocephalus during the rehabilitation of acute ischemic stroke.

Keyword

Cerebral salt wasting syndrome; Hyponatremia; Hydrocephalus; External lumbar drainage; Ventriculoperitoneal shunt

Figure

  • Fig. 1. (A) Image showing hydrocephalus with Evans ratio 36 at 2014 on flair brain magnetic resonance imaging. (B) Image showing hydrocephalus with Evans ratio 40 at 2019 on brain computed tomography.

  • Fig. 2. Summary of laboratory results during hospitalization. ELD, external lumbar drainage.


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