title: Refractory diabetes insipidus following drainage of chronic subdural haematoma.
abstract: BACKGROUND
  Post-traumatic diabetes insipidus (DI) is a relatively common complication after head injury. The authors report a fatal case of refractory DI, which developed in a patient with chronic subdural haematoma.
  
  
  METHODS
  A 38-year-old woman presented to the emergency room with a headache for over a week. She was alert and neurological examination demonstrated no significant deficits or external wounds in her head. Brain computed tomography (CT) scans revealed a small amount of chronic subdural haematoma bilaterally. She was treated conservatively and her hospital course was uneventful until she developed a convulsive seizure and mental change on the 3rd day after admission. Immediate follow-up CT scans showed no significant change in the amount of haemorrhage except effacement of gyral marking. Bilateral trephination and drainage of the haematoma were performed immediately. Post-operatively, she developed a refractory DI and was managed in the intensive care unit. However, she died on the 6th day after the operation ultimately.
  
  
  CONCLUSIONS
  The authors emphasize the importance of timely drainage of chronic subdural haematoma to prevent a fatal endocrinologic complication after head injury. This study also discusses the possible mechanism of DI after head injury, management and review of the pertinent literatures.
authors.affiliation: Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Yu Deok
authors.initials: YD
authors.lastname: Won
authors.forename: Choong Hyun
authors.initials: CH
authors.lastname: Kim
authors.forename: Jin Hwan
authors.initials: JH
authors.lastname: Cheong
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Kim
mesh_terms: D000328:Adult; D020790:Diabetes Insipidus, Neurogenic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D013997:Time Factors; D014057:Tomography, X-Ray Computed