علاج مرض السكري الكاذب المركزي بعد جراحة الغدة النخامية أو إصابة الدماغ الرضية أو النزيف تحت العنكبوتية

References

DOI: 10.1210/clinem/dgac381

• Acute onset of CDI is observed most frequently following transsphenoidal or transcranial surgery for pituitary tumor, TBI, and subarachnoid hemorrhage.
• The characteristic presentation is with sudden onset of polyuria, within 1 to 2 days following neurosurgery and later, with a median of 6 days after traumatic insult.
• CDI is diagnosed on the basis of hypernatremia associated with hypotonic urine, with no requirement to proceed to the WDT or measurement of AVP or copeptin.
• Treatment is based on limiting renal water losses with dDAVP; subsequent doses given as a single dose is occasionally sufficient with transient CDI.
• The patient should be allowed to drink water to thirst; if the patient is cognitively impaired, supplemental appropriate intravenous fluids can maintain eunatremia.
• Acute CDI is usually transient and may recede after a single dose of parenteral dDAVP.
• Further parenteral doses are only required if polyuria persists; a recent survey of pituitary endocrinologists found a strong consensus for the use of "on-demand" postoperative dDAVP rather than regular dosage.