gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Cerebral salt wasting in children with neurosurgical disease

CSW bei Kindern mit neurochirurgischen Erkrankungen

Meeting Abstract

  • corresponding author M. J. Fritsch - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • P. von Bismarck - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • T. Ankermann - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • P. Eggert - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • A. Claviez - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • M. F. Krause - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-11.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0142.shtml

Published: May 4, 2005

© 2005 Fritsch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

Cerebral salt wasting (CSW) is a medical complication in children with acute or chronic brain diseases and occurs at all ages beyond the neonatal period. Usually, stressful stimuli such as surgical procedures, general anesthesia or acute complications of chronic brain disease are known to cause CSW.

Methods

We present a case series of 9 patients with brain disease, negative sodium balance and polyuria seen in our institution within a 22 months period and describe the symptoms, patient characteristics (including hormone status), monitoring, treatment protocol and course of the disease.

Results

For induction of CSW, 4/9 patients presented with an acute complication of their prevalent chronic brain disease. 7/9 patients were subject to surgical procedures in general anesthesia, 4 of whom with manipulations of the brain or spinal chord. 2/9 children had CSW as an acute symptom of severe chronic brain disease triggered by unknown causes. Natriuresis and polyuria with increased Na+ turnover vanished within 2 weeks in 6/9 patients leaving 3 patients with longer courses of several weeks. Atrial and brain natriuretic peptides as a suspected cause of salt wasting were increased in only 5/9 of our patients. All children showed depressed plasma renin activity and low aldosterone levels.

Conclusions

CSW is eventually seen in chronic brain diseased children and can be triggered by a variety of acute brain complications or stressful stimuli. The length of the disease is self-limited and generally ceases within two weeks while substitution with adequate water and sodium intake should be monitored carefully.