A case report with a literature review: cerebral meningioma diagnosed by convulsion and consciousness disorder on initiating hemodialysis
| Autor: | Masayuki Otsuka, Koki Tokunaga, Miki Uwatoko, Akio Ido, Haruhito Yoshimine, Mako Kawano, Fujio Hamada, Yutaro Ibi, Masahisa Kamimura, Masato Minami |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Cerebral hypertension lcsh:RC870-923 Dialysis disequilibrium syndrome Cerebral edema Midline shift Internal medicine Azotemia medicine Intracranial pressure Transplantation Cerebral infarction business.industry medicine.disease lcsh:Diseases of the genitourinary system. Urology Occult brain tumor Introduction of hemodialysis Nephrology Anesthesia Dialysis disequilibrium syndromes Hemodialysis business Meningitis |
| Zdroj: | Renal Replacement Therapy, Vol 6, Iss 1, Pp 1-7 (2020) |
| ISSN: | 2059-1381 |
| Popis: | Background Neurological symptoms sometimes occur in hemodialysis patients, with causes including cerebral infarction, cerebral hemorrhaging, meningitis, and encephalitis. Dialysis disequilibrium syndrome (DDS) is widely known as a complication of hemodialysis and is typically encountered in severe uremic patients newly started on hemodialysis. The pathogenesis of DDS is thought to be brain edema that manifests as neurological symptoms, including headache, nausea, confusion, seizures, and coma. However, the relationship between brain tumors and neurological manifestations during hemodialysis is poorly understood. Case presentation The patient was a 55-year-old man with severe renal dysfunction and uremia symptoms. Blood chemistry showed severe azotemia and acidosis. The patient was placed on short-duration hemodialysis (2 h) with a relatively small surface area, low blood flow (100 mL/min), and intradialytic glycerol infusion to prevent DDS. However, after his first hemodialysis treatment, he complained of disturbed consciousness. We diagnosed his neurological condition as DDS and observed the progress carefully. The next morning, his symptoms had completely resolved, so the patient was started on his second hemodialysis session with the same conditions. However, 2 h after starting the second hemodialysis session, he suffered convulsions accompanied by impaired consciousness. Brain computed tomography (CT) revealed a convexity meningioma and cerebral edema with a midline shift. Before starting the hemodialysis, he had shown no history of seizures, morning headache, or other neurological symptoms. In this case, meningioma was diagnosed based on an increase in the intracranial pressure which occurred after the initiation of hemodialysis. Conclusion We report this suggestive case to prompt physicians to consider the potential effect of hemodialysis introduction on the brain pressure. |
| Databáze: | OpenAIRE |
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