Troy Patrick J, Clark Roger P, Kakarala Sri G, Burns Jocelyn, Silverman Isaac E, Shore Eric
Department of Internal Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA.
Neurocrit Care. 2005;2(1):55-8. doi: 10.1385/NCC:2:1:055.
Diabetic ketoacidosis (DKA) continues to be a medical emergency, in part because of a rare and devastating complication associated with its treatment, cerebral edema. In children, cerebral edema is the principal cause of mortality, but clinically significant cerebral edema in adults is rare.
We report the case of a 27-year-old male (not previously known to be diabetic) who presented with a first episode of DKA complicated by the development of fatal cerebral edema despite medical treatment.
The pathophysiological mechanisms for cerebral edema associated with DKA occurring in children and adults are believed to be similar and are discussed in this report. However, patients who develop cerebral edema may deteriorate rapidly, and experience with successful treatment has been limited.
糖尿病酮症酸中毒（DKA）仍然是一种医疗急症，部分原因是其治疗会引发一种罕见且严重的并发症——脑水肿。在儿童中，脑水肿是主要死因，但成人群体中具有临床意义的脑水肿较为罕见。
我们报告了一例27岁男性（既往不知患有糖尿病）的病例，该患者首次发作DKA，尽管接受了治疗，但仍并发致命性脑水肿。
儿童和成人DKA相关脑水肿的病理生理机制被认为是相似的，本报告对此进行了讨论。然而，发生脑水肿的患者可能会迅速恶化，且成功治疗的经验有限。
