[Serum hyposomolarity, brain edema and the bulbar brain syndrome as complications in the course of severe cranio-cerebral injuries in children].

It is reported on a severe craniocerebral trauma in a child with a rarely occurring spontaneously induced serum hypoosmolality which led to brain edema combined with intracranial increase of pressure and bulbar brain syndrome. By means of bedside brain ventricle catheterization for liquor drainage following drill-hole trepanation, the complication could be controlled. Later the recovery was completed under supervision of the outpatient department. Pathophysiological metabolic peculiarities, especially osmolality, are discussed. The necessity of special and repeated controls of the metabolic characteristics osmolality, sodium and potassium in serum and urine as well as the water and sodium balance within 24 hours is emphasized.