deamino-arginine-vasopressin and Wounds--Gunshot

Gunshot injuries (GSI) of the cranial area have an extremely high mortality rate. Herein, we present a girl who has been living with a bullet in the posterior sellar region. A 6-year-old girl was admitted with complaints of headache, polyuria and polydypsia, which started after a GSI. At the time of admission the patient's anthropometric, physical and neurological examinations were normal. Urine output was 5.5 L/m2/24h. A water deprivation test suggested central diabetes insipidus, which responded to treatment. Evaluation of other pituitary hormones revealed central hypothyroidism and growth hormone deficiency. Pituitary hormone deficiency must be kept in mind in patients injured by a gunshot to the sellar/parasellar region.

Topics: Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Female; Human Growth Hormone; Humans; Hypopituitarism; Hypothyroidism; Pituitary Hormones; Thyroxine; Wounds, Gunshot

Neuroendocrine dysfunctions are among the various complications that occur after traumatic brain injury. We report a case of onset of diabetes insipidus during acute rehabilitation of a 20-yr-old patient with a traumatic brain injury caused by a gunshot wound. Our case is the latest onset of diabetes insipidus after traumatic brain injury that has been reported in the literature.

Topics: Adult; Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Head Injuries, Penetrating; Humans; Hypopituitarism; Magnetic Resonance Imaging; Male; Osmolar Concentration; Pituitary-Adrenal Function Tests; Sodium; Specific Gravity; Time Factors; Water Deprivation; Wounds, Gunshot

Case report.. To present a case of central diabetes insipidus (CDI) that developed after a gunshot injury to the thorax and thoracic spinal cord and to discuss the disease process in light of the relevant literature.. Antidiuretic hormone (ADH) abnormalities may develop after spinal trauma and/or surgery. Although there are published reports of inappropriate ADH syndrome arising in this clinical picture, CDI is rare.. A 33-year-old woman with hemopneumothorax and a gunshot wound to her thoracic spine was treated with chest tube drainage. No surgery was performed for the spinal injury. The patient was paraplegic on admission and rapidly developed excessive urine output. Testing revealed that her serum ADH level was low, consistent with CDI. Desmopressin acetate nasal spray was the prescribed treatment.. The patient responded well to the desmopressin acetate spray.. CDI is a complicated hormonal disorder characterized by excessive urine output. It is typically linked to an abnormality in the hypothalamohypophyseal axis that markedly reduces ADH production. The most common inciting causes are craniocerebral trauma, brain tumor and/or surgery, and central nervous system infection. Although uncommon, CDI should be considered when a spinal trauma patient develops excessive urine output.

Topics: Administration, Intranasal; Adult; Atrophy; Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Female; Hemostatics; Humans; Magnetic Resonance Imaging; Spinal Cord; Spinal Cord Injuries; Thoracic Injuries; Thoracic Vertebrae; Thorax; Treatment Outcome; Wounds, Gunshot