Atormac
brintellex
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 1669  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed43    
    Printed0    
    Emailed0    
    PDF Downloaded45    
    Comments [Add]    

Recommend this journal

 

 REVIEW ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 7  |  Page : 101--105

Management of Water and Sodium Disturbances after Transsphenoidal Resection of Pituitary Tumors


Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA

Correspondence Address:
Dr. William T Couldwell
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT 84132
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.287679

Rights and Permissions

Patients with pituitary masses who undergo transsphenoidal resection are at risk for a number of medical complications postoperatively. Among these are disturbances in fluid and sodium homeostasis, including diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is believed that these pathologic states are a result of damage to the hypothalamic–pituitary axis from surgery, as are the downstream consequences, such as the triple phase response. The triple-phase response describes the pattern of initial acute DI, subsequent rebound SIADH, and eventual chronic DI, the pathophysiology of which is described. Given the medical complexity of managing postoperative pituitary patients, it is essential to develop dedicated postoperative management protocols. Here, we describe the University of Utah's postoperative pituitary management protocol that includes immediate postoperative monitoring, treatment of DI, surveillance for the triple-phase response after discharge with outpatient serum sodium checks, and involvement of the endocrinology service for assistance with management of hypopituitarism. A complete understanding of the relevant anatomy, physiology, and development of standardized protocols for postoperative management can aid with minimizing medical complications after pituitary surgery.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow