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Early hyponatraemia after pituitary surgery: cerebral salt-wasting syndrome

Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot S/N, 41013 Seville, Spain

(Correspondence should be addressed to R Guerrero; Email: rguerrerovazquez{at}yahoo.es)

Abstract

Hyponatraemia is a common complication in patients undergoing neurosurgery. It can be caused either by the syndrome of inappropriate secretion of antidiuretic hormone or by the cerebral salt-wasting syndrome (CSWS). CSWS frequently occurs in patients suffering from subarachnoid haemorrhage and brain injury, but it is rare after pituitary tumour surgery. However, this diagnostic possibility should be considered as these disorders require specific treatment and have different prognoses.

In this article, we present a case of acute and early hyponatraemia caused by CSWS after pituitary tumour surgery. We also revise the aetiology, mechanisms, differential diagnosis and treatment of hyponatraemia after pituitary surgery.