Development of severe hyponatremia due to cerebrospinal fluid leakage following meningomyelocele surgery in a newborn

Abstract

<jats:p>Cerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound-healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia’s cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.</jats:p>

Development of Inappropriate Vasopressin Secretion in Association With Lumbar Cerebrospinal Fluid Drainage in an Adult With Traumatic Basilar Skull Fracture

“…In infants, CSF drainage via repeated lumbar punctures, ventricular taps, externalized ventricular drains, ventriculoperitoneal shunts, and even CSF leak has been associated with hyponatremia due to direct sodium losses in the CSF. 2 , 3 , 4 The sodium concentration of CSF ranges from 135 to 150 mmol/L. 4 Sodium loss in a typical ventricular tap of 20 mL can be as much as 3 mmol, 2 whereas the daily sodium intake of a term infant would be around 6 mmol.…”

“… 2 , 3 , 4 The sodium concentration of CSF ranges from 135 to 150 mmol/L. 4 Sodium loss in a typical ventricular tap of 20 mL can be as much as 3 mmol, 2 whereas the daily sodium intake of a term infant would be around 6 mmol. 4 These infants are treated with oral sodium supplementation.…”

“… 4 Sodium loss in a typical ventricular tap of 20 mL can be as much as 3 mmol, 2 whereas the daily sodium intake of a term infant would be around 6 mmol. 4 These infants are treated with oral sodium supplementation. 2 , 3 , 4 Though hyponatremia with CSF drainage in pediatric patients is causal, direct sodium loss from CSF drainage would not explain hyponatremia in adults.…”

“… 4 These infants are treated with oral sodium supplementation. 2 , 3 , 4 Though hyponatremia with CSF drainage in pediatric patients is causal, direct sodium loss from CSF drainage would not explain hyponatremia in adults.…”

“…1 Cases of hyponatremia due to CSF drainage reported in the literature otherwise appear limited to the pediatric population, where the direct loss of sodium content with CSF drainage leads to hyponatremia. 2 , 3 , 4 …”