Abstract
Craniopharyngioma is associated with a wide and interesting variety of sodium states both by itself and following surgical resection. These are often challenging to diagnose, especially given their dynamic nature during the perioperative course. We present the case of a boy with craniopharyngioma who had hyponatremia due to cerebral salt wasting preoperatively, developed diabetes insipidus (DI) intraoperatively and proceeded to develop hypernatremia with adipsic DI.
Conclusion:
Cerebral salt wasting is a rare presenting feature of craniopharyngioma. Postoperative DI can be associated with thirst abnormalities including adipsia due to hypothalamic damage; careful monitoring and a high index of suspicion are required for its detection. Adipsic DI is a difficult condition to manage; hence a conservative surgical approach is suggested.
MeSH terms
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Central Nervous System Diseases / diagnostic imaging
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Central Nervous System Diseases / etiology
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Central Nervous System Diseases / pathology*
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Child
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Craniopharyngioma / complications
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Craniopharyngioma / diagnostic imaging
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Craniopharyngioma / pathology
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Craniopharyngioma / surgery*
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Diabetes Insipidus, Neurogenic / diagnostic imaging
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Diabetes Insipidus, Neurogenic / etiology
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Diabetes Insipidus, Neurogenic / pathology*
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Disease Progression
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Humans
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Hyponatremia / diagnostic imaging
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Hyponatremia / etiology
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Hyponatremia / pathology
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Male
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Pituitary Neoplasms / complications
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Pituitary Neoplasms / diagnostic imaging
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Pituitary Neoplasms / pathology
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Pituitary Neoplasms / surgery*
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Postoperative Complications / diagnostic imaging
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Postoperative Complications / pathology*
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Radiography
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Water-Electrolyte Imbalance / diagnostic imaging
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Water-Electrolyte Imbalance / etiology
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Water-Electrolyte Imbalance / pathology*