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Dyskalaemia following diffuse axonal injury: case report and review of the literature.

Abstract
Traumatic brain injury, and its management, commonly causes derangements in potassium balance. There are a number of recognised causative factors including head trauma, hypothermia and iatrogenic factors such as pharmacological agents and permissive cooling. We describe a case of a 19-year-old man with a severe traumatic brain injury. In a 36-h period, his intracranial pressure increased despite maximal medical therapy and he developed refractory hypokalaemia. Immediately following a decompressive craniectomy, the patient was noted to be profoundly hyperkalaemic; this led to the development of ventricular tachycardia and cardiac arrest, from which the patient did not recover. The effects of brain injury on potassium balance are not well appreciated; the effect of decompressive craniectomy on potassium (K(+)) balance has not been described previously. We would like to emphasise the potential effect of diffuse axonal injury, a severe form of brain injury and decompressive craniectomy on potassium balance.
AuthorsDavid Cronin, Chandrasekaran Kaliaperumal, Ramanathan Kumar, George Kaar
JournalBMJ case reports (BMJ Case Rep) Vol. 2012 (Oct 10 2012) ISSN: 1757-790X [Electronic] England
PMID23060370 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Potassium
Topics
  • Adult
  • Decompressive Craniectomy (adverse effects)
  • Diffuse Axonal Injury (blood, complications, surgery)
  • Fatal Outcome
  • Heart Arrest
  • Humans
  • Hyperkalemia (blood, etiology)
  • Hypokalemia (blood, etiology)
  • Male
  • Potassium (blood)
  • Young Adult

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