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Cited by 313Pituitary Gland Disorders and TreatmentsElectrolyte and hormonal disordersHead and Neck Surgical Oncology

Predictors of diabetes insipidus after transsphenoidal surgery: A review of 881 patients

Nemergut, Edward C., Zuo, Zhiyi, Jane, John A., Laws, Edward R.·2005·Journal of neurosurgery
DOI 10.3171/jns.2005.103.3.0448
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Abstract

OBJECT: Diabetes insipidus (DI) is a common complication of transsphenoidal surgery. The purpose of this study was to elucidate patient- and surgery-specific risk factors for DI. METHODS: The perioperative records of 881 patients who had undergone transsphenoidal microsurgery at the authors' institution between January 1995 and June 2001 were reviewed. Among 857 patients without preoperative DI, the overall incidence of immediate postoperative DI was 18.3%, with 12.4% of patients requiring treatment with desmopressin at some point during their hospitalization. Persistent DI requiring long-term treatment with desmopressin was noted in 2% of all patients. An observable intraoperative cerebrospinal fluid (CSF) leak was strongly associated with an increased incidence of both transient (33.3%) and persistent (4.4%) DI. Craniopharyngioma and Rathke cleft cyst (RCC) were also associated with an increased incidence of transient and persistent DI, whereas repeated operation was not. Among patients with pituitary adenomas, those with Cushing's disease had an increased risk of transient (22.2%), but not persistent, DI. Patients with a microadenoma were more likely to suffer transient DI than those harboring a macroadenoma (21.6 compared with 14.3%) but were not more likely to experience persistent DI. CONCLUSIONS: Diabetes insipidus remains a common complication of transsphenoidal surgery; however, it is most frequently transient in nature. Patients with an intraoperative CSF leak, a microadenoma, a craniopharyngioma, or an RCC appear to have an increased risk of transient DI. Risk factors for persistent DI include an intraoperative CSF leak, a craniopharyngioma, or an RCC.

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  • Disturbances in water homeostasis, most frequently due to cranial diabetes insipidus (DI), are commonly observed and appear to correlate with injury severity, with patients presenting lower GCS scores at higher risk.

    “Disturbances in water homeostasis, most frequently due to cranial diabetes insipidus (DI), are commonly observed and appear to correlate with injury severity, with patients presenting lower GCS scores at higher risk [63,64].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [63]

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Authors
Nemergut, E. C., Zuo, Z., Jane, J. A., & Laws, E. R.
Affiliations
University of Virginia Health System (US)
ORCID
Venue
Journal of neurosurgery
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Published
2005-09
Volume
103
Issue
3
Pages
448-454
ISSN
0022-3085 (ISSN-L)
DOI
10.3171/jns.2005.103.3.0448
OpenAlex
W2141699689
Cited by
313
References
34
Citations by year
2026: 7 · 2025: 18 · 2024: 21 · 2023: 21 · 2022: 26 · 2021: 22 · 2020: 17 · 2019: 15 · 2018: 16 · 2017: 20 · 2016: 10 · 2015: 24 · 2014: 8 · 2013: 14 · 2012: 14
FWCI
5.59
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
University of Virginia
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
  • Health Sciences › Medicine › Surgery › Head and Neck Surgical Oncology
Keywords
diabetes insipidus, transsphenoidal surgery, postoperative complications, risk factors, desmopressin, cerebrospinal fluid leak, craniopharyngioma, Rathke's cleft cyst, pituitary adenoma, Cushing's disease, pituitary microadenoma, macroadenoma
MeSH terms
Adenoma, Craniopharyngioma, Diabetes Insipidus, Humans, Pituitary Neoplasms, Prognosis, Retrospective Studies, Sphenoid Sinus, Subdural Effusion, Incidence, Central Nervous System Cysts

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