Abstract | BACKGROUND: CASE PRESENTATION: A 70-year-old Korean man visited emergency room complaining of sudden onset vertigo and gait disturbance. Neurological exam showed left side ataxia, Horner syndrome, and right side hypesthesia. Brain magnetic resonance imaging disclosed acute infarction involving left lateral medulla. His neurological status was stabilized, but he began to complain of non-vertiginous dizziness and general weakness five days after admission. Serum sodium level dropped from 131 mEq/mL to 122 mEq/mL with reduced serum osmolarity of 265 mOsm/L. The diagnosis of syndrome of inappropriate secretion of antidiuretic hormone was made and we restricted fluid intake, but his symptoms worsened and his mental status became drowsy. Follow up serum sodium level was 108 mEq/L with volume loss, suggesting cerebral salt wasting syndrome. We treated him with hypertonic saline and his consciousness was recovered. CONCLUSION:
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Authors | Jeong-Min Kim, Kwang-Yeol Park, Do Hyoung Kim, Jae-Han Bae, Dong-Woo Shin, Young Chul Youn, Oh-Sang Kwon |
Journal | BMC neurology
(BMC Neurol)
Vol. 14
Pg. 111
(May 22 2014)
ISSN: 1471-2377 [Electronic] England |
PMID | 24886592
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Cerebral Infarction
(blood, complications, metabolism)
- Humans
- Hyponatremia
(blood, etiology, metabolism)
- Inappropriate ADH Syndrome
(blood, complications, metabolism)
- Male
- Medulla Oblongata
- Middle Aged
- Sodium
(blood)
- Unconsciousness
(etiology)
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