• Zhen Junhai, Yan Jing, and Li Li.
• Department of Critical Care Medicine, Zhejiang Hospital, Lingyin Road NO.12, Hangzhou, 310013, China.
• J Natl Med Assoc. 2020 Jun 1; 112 (3): 258-261.

BackgroundCerebral salt-wasting syndrome (CSWS), which usually secondary to cerebral diseases, is characterized by hyponatremia and hypovolemia. In clinical practice, it is quite difficult to distinguish CSWS from other hyponatremia syndrome, especially in Intensive Care Unit (ICU) where the conditions of patients are more complicated. Nonetheless, it is crucial because treatments might be fundamentally different.Case PresentationWe discuss a case of patient who presented with refractory hyponatremia and hypovolemia after traumatic brain injury, finally was diagnosed with CSWS, and successfully treated with corticotropin.ConclusionsThis case report provides a unique opportunity to observe the trigger of subdural effusion-induced CSWS, and also it provides the classical therapy for CSWS in a critically ill patient. In view of the difficulty to tell CSWS from other similar diseases in ICU, ICU doctors should be aware of such condition.Copyright © 2020 National Medical Association. Published by Elsevier Inc. All rights reserved.

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