Abstract
Early diagnosis and treatment of hydrocephalus are necessary for successful outcome. The advent of computerized axial tomography (CAT) scans has facilitated diagnosis. Unless CAT scan is performed routinely, however, diagnosis at the earliest operable stage may be missed.
The charts were reviewed of 35 neonates weighing ≤2000 gms. at birth who received CAT scan evaluations for detection of hydrocephalus. Serum Na levels were measured as part of their routine care. Infants with meningitis or meningomyelocele were excluded from the review as were infants who died prior to 28 days of age.
Nine infants had hydrocephalus. Five of these infants had verified (repeated) serum Na levels of ≤125 meq/L which occurred 1 to 62 days prior to diagnosis of hydrocephalus. Of the 26 infants whose CAT scan did not reveal hydrocephalus, only 4 had verified hyponatremia. (X2=5.6; p<0.05).
The etiology of the low serum Na levels in the infants who later developed hydrocephalus is unclear. Low Na intake by itself appears to be an unlikely etiology. Spot urine Na levels, urine and serum osmolalities, and increments in infants' weights were not totally consistent with inappropriate anti-diuretic hormone secretion. Presence of hyponatremia may be a high risk marker which identifies the infant at greater risk of subsequent development of hydrocephalus.
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Pomerance, J., Perlin, B., Sanchez, R. et al. 1148 HYPONATREMIA AS A POSSIBLE SIGN OF IMPENDING HYDROCEPHALUS IN INFANTS ≥2000 GMS. AT BIRTH. Pediatr Res 12 (Suppl 4), 555 (1978). https://doi.org/10.1203/00006450-197804001-01154
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DOI: https://doi.org/10.1203/00006450-197804001-01154
