Hyponatremia initial presenting feature of normal pressure hydrocephalus in elderly patient: a rare case report

S. Kumar, P. Bhayani, D. Hathi, J. Bhagwati

Jawahar Lal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University): Wardha, Maharashtra, India

A 70 year old male presented with unsteadiness, declining cognitive functions and urinary incontinence, with serum sodium level of 108 meq/L and serum osmolality of 268 mosm/kg. His computerized tomography scan of Brain showed ventriculomegaly which made us to keep the possibility of Normal Pressure Hydrocephalus (NPH). This case report highlights about suspecting syndrome of inappropriate antidiuretic hormone secretion (SIADH) due to hyponatremia as an important differential in a case of Normal Pressure Hydrocephalus. Theoretically, hyponatremia may occur in NPH, but only three associated cases of SIADH have previously been reported in the literature and first in India.

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