ABSTRACT
Central pontine myelinolysis is a fatal complication that is due to rapid correction of hyponatraemia. An acute onset of paralysis, dysarthria, dysphagia, diplopia and eventual loss of consciousness may occur following correction. Clinical vasospasm can present with a reduced Glasgow Coma scale score or delayed ischaemic neurological deficit (stroke) and is considered to occur as a result of irritation of the blood vessels by the subarachnoid blood. If the mass enlarges further, it exceeds the critical level and the Intracranial Pressure (ICP) then increases very rapidly as auto-regulation fails. In these patients, mannitol (a diuretic) can be used to reduce the ICP prior to more definitive neurosurgical intervention. If the mass enlarges further, it exceeds the critical level and the ICP then increases very rapidly as auto-regulation fails. In these patients, mannitol (a diuretic) can be used to reduce the ICP prior to more definitive neurosurgical intervention.
