Dementia due to acute hyponatremic encephalopathy in an elderly patient with arnold chiari I Sindrome

Symptoms and signs of hyponatriemic encephalopathy are reported in 0.15 % of hospitalized patients. It is very important to recognize whether hyponatremia is of acute or chronic character, because these two forms require different therapeutic approaches. A 65- year-old male patient operated because of necrotic hemorrhagic pancreatitis, carne to our observation with gait and balance disorders, as well as neurologica! disturbancee. He showed a persistent hyponatremia and hypopotassemia. Magnetic resonance imaging revealed thè presence of Arnold-Chiari-I anomaly (AC-I). He was treated with infusion of hypertonic sodium chloride at various doses for 3 days, unti! thè normalization of natremia and potassemia was achieved. After one week, thè patient was discharged in good generai conditions. This case report highlights that that thè correction of symptomatic hyponatremia is a fundamentally simple intervention, but it may save thè life of patients who carry earlier malformations such as AC-I, which increase thè risk of cerebellar herniation in these electrolytic imbalances.