Brain Injury Syndrome of inappropriate antidiuretic hormone secretion clinical analysis of 20 cases.docVIP

 PAGE \* MERGEFORMAT 9 Brain Injury Syndrome of inappropriate antidiuretic hormone secretion clinical analysis of 20 cases Keywords: Brain Injury Syndrome of inappropriate antidiuretic hormone secretion Hyponatremia after head injury when the anomaly syndrome of inappropriate antidiuretic hormone secretion (SIADH) compared with cerebral salt wasting syndrome (CSWS) rare. To further enhance the understanding of this disease, the authors collected our hospital from January 2005 to October 2006 20 patients, combined with literature on the SIADH etiology, pathogenesis, diagnosis, differential diagnosis and treatment of the following analysis. A clinical data 1.1 General information on 20 cases of patients in this group 12 males and 8 females; aged 18 to 72 years, mean 45 years. Both traumatic brain injury patients, including 8 cases of subdural hematoma, diffuse axonal injury in 1 case, 6 cases of intracerebral hematoma, cerebral contusion with subdural hematoma in 5 cases. This group of patients with Glasgow coma scale (GCS) score 8 to 14 minutes. 1.2 clinical manifestations of surgical treatment of patients in this group 7 cases, conservative treatment of 13 cases. The admission or after surgery according to normal physiological requirement to add intravenous electrolyte, while for the anti-infection, dehydration, bleeding and other conventional treatment. Patients were 5 ~ 10d after treatment appears hyponatremia. First manifestation of the spirit of apathetic, conscious indifference, lethargy and even coma. In which there abdominal distention, cramps, each 1 case. Laboratory examination showed hyponatremia, or serum sodium lt;130mmol / L; and a urinary sodiumgt; 80mmol/24h; plasma osmolality lt;270mmol / L, urine osmolality higher than plasma osmolality and plasma arginine vasopressin hormone (AVP)gt; 1.5ng / L. 1.3 Treatment of light by water restrictions, while giving the adrenocorticotropic hormone (ACTH) treatm