Hydrocephalus requiring urgent external ventricular drainage in a patient with diabetic ketoacidosis and cerebral edema: Case report

Emad N. Eskandar, Simcha J. Weller, David M. Frim

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Neurological deterioration, typically attributed to cerebral edema, is a rare but life-threatening complication in the treatment of diabetic ketoacidosis (DKA). We report the case of a child with DKA who became comatose but demonstrated acute obstructive hydrocephalus, instead of cerebral edema. CLINICAL PRESENTATION: An 11-year- old male patient presented with new-onset insulin-dependent diabetes mellitus and DKA. He was initially responsive but, after several hours of treatment, became unresponsive, with dilated pupils and decerebrate posturing. Cranial computed tomographic scanning demonstrated obstructive hydrocephalus resulting from focal cerebellar and brain stem edema. INTERVENTION: The patient was initially managed with medical treatment but ultimately required urgent ventricular drainage to arrest a progressive herniation syndrome. To our knowledge, this report describes only the second such case reported and the first requiring urgent ventriculostomy. CONCLUSIONS: These observations emphasize the importance of recognizing hydrocephalus as a potentially reversible cause of coma in DKA and of initiating prompt neurosurgical intervention, if warranted.

Original languageEnglish (US)
Pages (from-to)836-839
Number of pages4
JournalNeurosurgery
Volume40
Issue number4
DOIs
StatePublished - Apr 1 1997
Externally publishedYes

Fingerprint

Diabetic Ketoacidosis
Brain Edema
Hydrocephalus
Drainage
Coma
Decerebrate State
Ventriculostomy
Pupil
Type 1 Diabetes Mellitus
Brain Stem
Therapeutics

Keywords

  • Cerebral edema
  • Diabetic ketoacidosis
  • Hydrocephalus
  • Ventriculostomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Hydrocephalus requiring urgent external ventricular drainage in a patient with diabetic ketoacidosis and cerebral edema : Case report. / Eskandar, Emad N.; Weller, Simcha J.; Frim, David M.

In: Neurosurgery, Vol. 40, No. 4, 01.04.1997, p. 836-839.

Research output: Contribution to journalArticle

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