Case presentation:
We report a 15-year-old female adolescent, admitted to intensive care
for acute severe traumatic brain injury. During his hospitalization, she
developed a hyponatremia with an increase of urine output and
hypovolemia. So, the most probable diagnosis was CSW. Initially she was
treated by hypertonic saline and volume expansion. However, his sodium
level continued to fall despite infusion of hypertonic saline. That is
why fludrocortisone was introduced initially at 50 µg/day then increased
to 150 µg/day. Fludrocortisone was continued for the next months. Serum
sodium level was 138 mmol/L after one month of treatment.