Journal of the Korean Pediatric Society 1999;42(12):1702-1710.
Published online December 15, 1999.
Central Diabetes Insipidus in Children Related to Craniotomy for a Brain Tumor
Seung Mi Song1, Eun Jung Park1, Jung Sim Kim1, Hong Hoe Koo1, Mun Hyang Lee1, Hyung Jin Shin2, Dong Kyu Jin1
1Department of Pediatrics, College of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea
2Department of Neurosurgery, College of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea
뇌종양 수술 전후로 발생한 중추성 요붕증에 관한 임상고찰
송승미1, 박은정1, 김정심1, 구홍회1, 이문향1, 신형진2, 진동규1
1성균관대학교 의과대학 삼성서울병원 소아과
2성균관대학교 의과대학 삼성서울병원 신경외과
Correspondence: 
Dong Kyu Jin, Email: 1
Abstract
Purpose
: Diabetes insipidus(DI) has been known to be a relatively common complication after craniotomy. We have investigated the incidence and clinical course of DI in children related to craniotomy for a brain tumor and determined the risk factors of postoperative DI.
Methods
: Sixty-two pediatric patients, who have undergone craniotomy for a brain tumor(including stereotactic biopsy) from February 1995 through January 1998, were included in this study. We reviewed hospital records retrospectively and analyzed daily fluid intake and output, electrolytes and osmolarity of serum and urine, and urine specific gravity.
Results
: Of 62 patients, DI developed preoperatively in 7 patients and postoperatively in 7 patients. Preoperative DI composed of 4 germinoma, 2 craniopharyngioma and a histiocytosis, followed by permanent DI after operation. All of the postoperative DI were composed of suprasellar tumors, including 4 craniopharyngioma, which progressed to permanent DI in 5 cases and transient DI in 2 cases. The 5 patients had a triphasic response. The initial phase of DI began within 12 hours postoperatively followed by antidiuretic phase at the 2nd-6th postoperative day, lasted 1-6 days and finally all patients entered permanent DI. Hypopituitarism developed in 10 patients and all of them were accompanied by permanent DI.
Conclusion
: DI is a common complication after neurosurgery for the hypothalamic or pituitary area. The high-risk factors of permanant DI are preoperative DI, combined hypopituitarism or triphasic response. Therefore, it is important to closely monitor this high-risk group, and we should consider endocrinological evaluation in patients who had undergone craniotomy for a brain tumor.
Key Words: Diabetes insipidus, Brain tumor, Craniotomy, Children


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