뇌동맥류 결찰술 직후 발생한 중추성 요붕증과 동반된 SIADH 1 예

초록

Dysnatremia is one of common medical complications after surgical treatment of subarachnoid hemorrhage (SAH) due to cerebral aneurysm. We report a case of transient central diabetes insipidus (DI) followed by syndrome of inappropriate antidiuretic hormone secretion (SIADH), after direct clipping of ruptured cerebral aneurysm. A 60-year-old woman presented visual defect of right temporal area due to large paraclinoid aneurysm. During operation, the neck of aneurysm was ruptured, but successfully clipped. Just after the operation polyuria and hypernatremia developed and biochemical findings revealed that the patient presented central DI. A few days after recovery from hypernatremia, hyponatremia occurred and laboratory work revealed SIADH, and after free water restriction the patient was recovered from hyponatremia. Therefore, we suggest to monitor abrupt hypernatremia after operation and to implement rigorous fluid therapy, considering hyponatremia after recovery.

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