Key result
Tolvaptan successfully normalized serum sodium levels to 137 mEq/L in a 70-year-old male presenting with refractory hyponatremia secondary to a delayed chronic subdural hematoma after head trauma.
Case Report (n=1)
Refractory hyponatremia after head trauma should raise suspicion for delayed intracranial hemorrhage, which can be successfully managed with tolvaptan.
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Suggests tolvaptan may offer a salvage strategy for refractory hyponatremia in.
Here, we report a case of refractory hyponatremia and delayed intracranial hemorrhage following a head injury. A 70-year-old male patient was admitted with complaints of left chest pain and light-headedness after a fall. Hyponatremia recurred despite the correction with intravenous saline. Head computed tomography revealed a chronic subdural hematoma. The subsequent introduction of tolvaptan improved hyponatremia and disorientation. Delayed intracranial hemorrhage is a differential cause of refractory hyponatremia after head contusion. This case is clinically relevant because (i) the diagnostic delay of late-onset intracranial hemorrhage is common but fatal, and (ii) refractory hyponatremia can be a hint of late-onset intracranial hemorrhage.
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Lee et al. (2023) conducted a case report in Refractory hyponatremia and delayed intracranial hemorrhage (n=1). Tolvaptan was evaluated on Serum sodium level. Tolvaptan successfully normalized serum sodium levels to 137 mEq/L in a 70-year-old male presenting with refractory hyponatremia secondary to a delayed chronic subdural hematoma after head trauma.
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