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Vol. 23. Num. 1.January 2012
Pages 1-46
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Vol. 23. Num. 1.January 2012
Pages 1-46
DOI: 10.1016/j.neucir.2011.08.001
Cerebral salt wasting syndrome, postoperative complication in tumours of the cerebellopontine angle
Síndrome pierde sal cerebral, complicación posquirúrgica en tumores del ángulo pontocerebeloso
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Fernando Ruiz-Juretschkea, Miguel Arísteguib, Roberto García-Leala, Carlos Fernández-Carballala, Alejandro Lowyb, Carlos Martin-Oviedob, Teresa Panaderoa
a Department of Neurosurgery, Hospital General Universitario Gregorio Mara????n, Madrid, Spain
b Department of Otolaryngology, Hospital General Universitario Gregorio Mara????n, Madrid, Spain
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Table 1. - Differential diagnosis of cerebral salt wasting (CSW) and syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 

El síndrome pierde sal cerebral (CSW, en sus siglas en inglés) es una complicación rara en la cirugía de los tumores de la fosa posterior. Presentamos a 2 pacientes con tumores del ángulo pontocerebeloso que desarrollaron un CSW posquirúrgico. Ambos pacientes tuvieron un empeoramiento pese a la fluidoterapia y la reposición de sal intensivas. La tomografía computarizada (TC) mostraba una dilatación ventricular leve a moderada que fue tratada mediante un drenaje ventricular externo. Tras la resolución de la hidrocefalia el balance hidroelectrolítico se normalizó rápidamente en ambos pacientes y su situación clínica mejoró. La identificación y el tratamiento precoz de la hidrocefalia obstructiva pueden contribuir al tratamiento del síndrome pierde sal asociado a la cirugía de tumores de la fosa posterior.

Palabras clave:
Tumor del ángulo pontocerebeloso
Síndrome pierde sal cerebral
Hidrocefalia
Hiponatremia
Cirugía

Cerebral salt wasting (CSW) is a rare complication in posterior fossa tumour surgery. We present two patients with cerebellopontine angle (CPA) tumours who developed cerebral salt wasting postoperatively. Both patients deteriorated in spite of intensive fluid and salt replacement. On CT scan the patients presented mild to moderate ventricular dilation, which was treated with an external ventricular drainage. After the resolution of hydrocephalus, fluid balance rapidly returned to normal in both patients and the clinical status improved. Identification and treatment of secondary obstructive hydrocephalus may contribute to the management of CSW associated to posterior fossa tumour surgery.

Keywords:
Cerebellopontine angle tumour
Cerebral salt wasting
Hydrocephalus
Hyponatraemia
Surgery

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