Journal of Medical Sciences

CASE REPORT
Year
: 2016  |  Volume : 36  |  Issue : 1  |  Page : 28--30

Altered consciousness following head injury in advanced renal failure: Find the culprit


Kun-Lin Wu, Sung-Sen Yang, Chih-Chien Sung, Shih-Hua Lin 
 Department of Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei; Department of Medicine, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan, Republic of China

Correspondence Address:
Shih-Hua Lin
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
Republic of China

Conscious change following head injury needs a scrutiny of the «DQ»nontraumatic«DQ» cause to avoid inappropriate management and catastrophic complication. We described an 81-year-old diabetic woman with advanced chronic kidney disease (CKD) (estimated glomerular filtration rate: 6 ml/min/1.73 m 2 ) re-presented to Emergency Department with altered mentality and generalized muscular hypotonia 2 days after falling with a head injury. Her initial mentality was alert, and computed tomography of the brain was negative for organic lesions; she has been given oral baclofen 10 mg daily to control her associated spastic back pain. The repeated laboratory and imaging studies were still unrevealing. Her serum baclofen concentration was markedly elevated (1437 ng/ml). With emergent hemodialysis for two sessions, complete elimination of serum baclofen concentration was accompanied by full recovery of her consciousness. Nontraumatic causes, especially drug-induced neurotoxicity, must be kept in mind in traumatic patients with CKD and unexplained neurological feature.


How to cite this article:
Wu KL, Yang SS, Sung CC, Lin SH. Altered consciousness following head injury in advanced renal failure: Find the culprit.J Med Sci 2016;36:28-30


How to cite this URL:
Wu KL, Yang SS, Sung CC, Lin SH. Altered consciousness following head injury in advanced renal failure: Find the culprit. J Med Sci [serial online] 2016 [cited 2020 Aug 14 ];36:28-30
Available from: http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2016;volume=36;issue=1;spage=28;epage=30;aulast=Wu;type=0