Diabetes Insipidus Secondary to Penetrating Spinal Cord Trauma

Kuzeylı, Kayhan; Çakır, Ertuğrul; Baykal, Süleyman; Karaarslan, Gökalp

doi:10.1097/00007632-200111010-00023

Cited by 17 publications

(17 citation statements)

References 9 publications

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“…Several studies have reported that patients undergoing spine surgery or spinal cord trauma patients developed excessive urine output [16]. Second, it has been reported that calcium channel antagonists enhance the diuretic activity of dexmedetomidine in rats by directly inhibiting renal tubular water and electrolyte reabsorption and blocking the inhibitory actions of angiotensin and vasopressin on renin secretion [15]. In the present case, the patient had taken a calcium channel antagonist (felodipine) for hypertension.…”

Section: Discussionmentioning

confidence: 63%

“…grav. U urine specific gravity, Osm U urine osmolality (mOsm/kg H 2 O), Osm P plasma osmolality (mOsm/kg H 2 O), BUN blood urea nitrogen, Cr blood creatinine, BP arterial blood pressure (mmHg), HR heart rate (beats/min), CO cardiac output, SVV stroke volume variation, EBL estimated blood loss (ml), UOP urine output (ml), AR Ringer's acetate solution, NS normal saline, HES hydroxyethyl starch, PRBC packed blood red cells, FFP fresh frozen plasma, D5W 5 % dextrose solution, NR not recorded, POD postoperative day effect and a dose-dependent increase in the frequency of voiding [15]. Although dexmedetomidine-induced polyuria and hypernatremia may be explained by the previously stated mechanisms, studies in human are still sparse.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative hypernatremia and polyuric syndrome induced by dexmedetomidine

2013

J Anesth

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Hypernatremia and polyuria are the main symptoms of diabetes insipidus. Polyuria is characterized by a 24-h urine volume in excess of 40-50 ml/kg in adults. Dexmedetomidine, a highly selective, short-acting intravenous alpha-2 agonist, is used as a component of anesthesia, and has been suspected to induce polyuric syndrome. We report a patient who presented with severe hypernatremia and polyuria after intravenous infusion of dexmedetomidine.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Intraoperative hypernatremia and polyuric syndrome induced by dexmedetomidine

2013

J Anesth

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“…42,43 An interesting particularity noticed in one of our subjects was the triple association between AS-SCI and a transient diabetes insipidus.…”

Section: Discussionmentioning

confidence: 73%

Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

Anghelescu

Onose²,

Popescu

et al. 2016

Spinal Cord Ser Cases

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The ankylosing spondylitis (AS) is a systemic, multi-factorial, chronic rheumatic disease. Patients are highly susceptible to vertebral fractures with or without spinal cord injury (AS-SCI), even after a minor trauma. The study is a retrospective descriptive survey of post-acute, traumatic AS-SCI patients, transferred from the neurosurgical department and admitted in a Romanian Neurorehabilitation Clinic, during 2010-2014. There were 11 males associating AS-SCI (0.90% of all consecutive SCI admitted cases), with an average age of 54.6 years (median 56, limits 42-73 years). The average duration between the medically diagnosed AS and the actual associated spinal fracture(-s) moment was 21.4 years (median 23; limits 10-34 years). Low-energy trauma was incriminated in 54.5% cases. The spinal level of fracture was: cervical (four cases), thoracic (three), lumbar (four), assessed at admission as: American Spinal Injury Association (ASIA) Impairment Scale (AIS) A (four subjects), C (five) and D (two). By the time of discharge, neither patient has neurologically deteriorated; five patients (45.5%) improved of at least grade 1 (AIS). The overall complications were mainly infections: symptomatic urinary tract infections (seven patients; 63.6%), pulmonary (three subjects; 27.3%) and spondylodiscitis (one case; 9%). The average follow-up period was 15.3 months (median 12; limits 1-48 months) after discharge; three subjects gained functional improvement to AIS-E. The clinical profile (different risk factors, mechanisms, types and levels of spinal fractures, additional encephalic and/or cord lesions, co-morbidities), different post-surgical and/or general complications acquired during admission in our rehabilitation ward, served us for future prevention strategies and a better therapeutic management.

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“…4,5 It has been hypothesized that CDI can be caused by spinal injury if there is hypoperfusion and hypoxia of the neurohypophysis and median eminence as a result of vasomotor instability. 6 Farelli and Staas 2 described a quadriplegic patient with partial CDI, which is a mild form of the disease, diagnosed after the spinal trauma because the patient could not spontaneously empty his bladder. An intermittent catheterization program was unmanageable due to his production of a copious amount of urine.…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Polyuria and Polydipsia in a Patient with Spinal Cord Injury

Ölmez²,

Memiş³

et al. 2005

American Journal of Physical Medicine & Rehabilitation

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We report the case of a 35-yr-old tetraplegic man who experienced increased water intake, constant thirst, and a copious amount of urine excretion after his spinal cord injury and in whom an intermittent catheterization program was unmanageable. Laboratory evaluation revealed low serum and urine osmolality, which were suggestive of psychogenic polydipsia, and hypokalemia, which might lead to polyuria with a compensatory polydipsia. His water intake was reduced with antidepressant therapy and potassium supplementation and normalized on the third month of the treatment. Physicians should be aware of the differential diagnosis of polyuria and polydipsia, which interfere with neurogenic bladder management in patients with spinal cord injury.

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Diabetes Insipidus Secondary to Penetrating Spinal Cord Trauma

Cited by 17 publications

References 9 publications

Intraoperative hypernatremia and polyuric syndrome induced by dexmedetomidine

Intraoperative hypernatremia and polyuric syndrome induced by dexmedetomidine

Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

Differential Diagnosis of Polyuria and Polydipsia in a Patient with Spinal Cord Injury

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