Survival with Serum Sodium Level of 180 mEq/L: Permanent Disorientation to Place and Time
作者:
Joaquin Gomez-Daspet,
Lucinda Elko,
Dmitry Grebenev,
David Vesely,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 2002)
卷期:
Volume 324,
issue 6
页码: 321-325
ISSN:0002-9629
年代: 2002
出版商: OVID
关键词: Hypernatremia;mortality;neurologic deficits, pituitary tumor;diabetes insipidus
数据来源: OVID
摘要:
A 41-year-old woman who had undergone transfrontal craniotomy for a pituitary tumor 4 months before presentation was admitted with confusion and orientation only to self. She had a fever of 40°C. Serum sodium and chloride levels on admission were 180 and 139 mEq/L, respectively. Measured serum osmolality was 380 mOsmol/L with a urine osmolality of 360 mOsmol/L. Magnetic resonance imaging revealed a 1.5-cm mass in the sella turcica, which was nonfunctioning on endocrine evaluation. The “bright spot” of a normal posterior pituitary was absent. Central diabetes insipidus was confirmed by a 300% increase in urine osmolality with desmopressin. The patient survived her severe hypernatremia, which has 70% mortality with a serum sodium level of 160 mEq/L or above. However, she developed permanent (6 months) disorientation to time and place even when hypernatremia was corrected, which has not been described previously.
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