Dyskalaemia following diffuse axonal injury: case report and review of the literature.
Traumatic brain injury, and its management, commonly causes derangements in potassium balance. There are a number of recognised causative factors including head trauma, hypothermia and iatrogenic factors such as pharmacological agents and permissive cooling. We describe a case of a 19-year-old man with a severe traumatic brain injury. In a 36-h period, his intracranial pressure increased despite maximal medical therapy and he developed refractory hypokalaemia. Immediately following a decompressive craniectomy, the patient was noted to be profoundly hyperkalaemic; this led to the development of ventricular tachycardia and cardiac arrest, from which the patient did not recover. The effects of brain injury on potassium balance are not well appreciated; the effect of decompressive craniectomy on potassium (K(+)) balance has not been described previously. We would like to emphasise the potential effect of diffuse axonal injury, a severe form of brain injury and decompressive craniectomy on potassium balance.
Department of Neurosurgery, Cork University Hospital, Cork, Ireland.
David
D
Cronin
Chandrasekaran
C
Kaliaperumal
Ramanathan
R
Kumar
George
G
Kaar
D000328:Adult; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D020833:Diffuse Axonal Injury / Q000097:blood / Q000150:complications* / Q000601:surgery*; D017809:Fatal Outcome; D006323:Heart Arrest; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000209:etiology*; D007008:Hypokalemia / Q000097:blood / Q000209:etiology*; D008297:Male; D011188:Potassium / Q000097:blood; D055815:Young Adult
D011188:Potassium