Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Dialysis Disequilibrium Syndrome in Neurosurgical Patient - Case Report -

신경외과 환자 치료 중 발생한 Dialysis Disequilibrium Syndrome - 증례보고 -

  • Woo, Hee-Kyung (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Yoo, Do-Sung (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Kim, Dal-Soo (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Huh, Pil-Woo (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Cho, Kyoung-Suok (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Kang, Joon-Ki (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine)
  • 우희경 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
  • 유도성 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
  • 김달수 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
  • 허필우 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
  • 조경석 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
  • 강준기 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실)
  • Received : 2000.07.04
  • Accepted : 2000.11.30
  • Published : 2001.03.28
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Abstract

Neurological symptoms may develope when the blood urea nitrogen is lowered too rapidly by hemodialysis. It is known that these symptoms, known as dialysis disequilibrium are associated with cerebral edema. However, the pathogenesis of brain swelling and neurological deterioration after rapid hemodialysis is controversial. The reverse urea hypothesis suggests that hemodialysis removes urea more slowly from the brain than from the plasma, creating an osmotic gradient that results in cerebral edema. The idiogenic osmole hypothesis proposes that an osmotic gradient between brain and plasma develops during rapid dialysis because of newly formed brain osmoles. Authors report a such case and discuss the possible mechanism and preventive methods.

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