Bu vaka, kafa travması olmaksızın akut travmatik servikal omurilik yaralanmasını takiben ortaya çıkan nadir bir komplikasyon olan santral diabetes insipidusun (SDİ) klinik önemini vurgulamaktadır. Bu çalışmanın amacı, rehabilitasyon sürecinde SDİ’nin göz önünde bulundurulmasının önemini vurgulamaktır. Yirmi beş yaşındaki erkek hasta C4 ASIA A tanısı ile takip ediliyordu. Hastanın değerlendirmelerinde kafa travmasının eşlik etmediği saptandı. Hastanın takiplerinde, ağız kuruluğu, aşırı susama ve artmış su tüketimi şikâyetleri gelişmiştir. Hastaya SDİ tanısı konulmuştur. Hastanede yatış süresince hastanın günlük sıvı alımı 3.000-4.000 mL arasında değişmiştir. Sıkı bir sıvı rejimi ve idrar takibi ile hastanın laboratuvar bulguları 2 hafta içinde düzelmiştir. Omurilik yaralanmalarına eşlik edebilecek diabetes inspidus semptomlarının farkında olunması, uygun tedavi ve sıvı yönetim stratejilerinin hızla uygulanmasını sağlar. Bu durum, hastaların genel sağlığının korunmasına yardımcı olur ve potansiyel komplikasyonları en aza indirir.

This report highlights the clinical significance of central diabetes insipidus (CDI), a rare complication that arises following acute traumatic cervical spinal cord injury without head injury. The aim was to emphasize the importance of considering CDI during the rehabilitation process. A 25-year-old male patient diagnosed with a C4 level (ASIA A). No head trauma was detected in the patient's examinations. The patient reported symptoms of dry mouth, excessive thirst, and increased water intake during the neurosurgery clinic evaluation. The patient was diagnosed with CDI. During hospitalization, the patient's fluid intake ranged from 3,000 to 4,000 mL daily. With a strict fluid regimen and urine monitoring, the patient’s laboratory findings improved within 2 weeks. Being aware of the potential symptoms of diabetes insipidus that may accompany spinal cord injuries enables the rapid implementation of appropriate treatment and fluid management strategies. This helps maintain the patients’ overall health and minimizes potential complications.

1. Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34:535-46. [Crossref]  [PubMed]  [PMC] 
2. Jain NB, Ayers GD, Peterson EN, Harris MB, Morse L, O'Connor KC, Garshick E. Traumatic spinal cord injury in the United States, 1993-2012. JAMA. 2015 Jun 9;313(22):2236-43. [Crossref]  [PubMed]  [PMC] 
3. Jackson AB, Dijkers M, Devivo MJ, et al. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil. 2004;85:1740-8. [Crossref]  [PubMed] 
4. Karacan I, Koyuncu H, Pekel O, et al. Traumatic spinal cord injuries in Turkey: a nation-wide epidemiological study. Spinal Cord. 2000;38:697-701. [Crossref]  [PubMed] 
5. Devivo MJ. Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord. 2012;50:365-72. [Crossref]  [PubMed] 
6. Wahman K, Nilsson Wikmar L, Chlaidze G, et al. Secondary medical complications after traumatic spinal cord injury in Stockholm, Sweden: Towards developing prevention strategies. J Rehabil Med. 2019;51:513-7. [Crossref]  [PubMed] 
7. Gubbi S, Hannah-Shmouni F, Koch CA, et al. Diagnostic Testing for Diabetes Insipidus. 2022 Nov 28. In: Feingold KR, Anawalt B, Blackman MR, et al, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. [PubMed] 
8. Hui C, Khan M, Khan Suheb MZ, et al. Arginine Vasopressin Disorder (Diabetes Insipidus). 2024. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. [PubMed] 
9. Alaca R, Yilmaz B, Gunduz S. Anterior hypopituitarism with unusual delayed onset of diabetes insipidus after penetrating head injury. Am J Phys Med Rehabil. 2002;81:788-91. [Crossref]  [PubMed] 
10. Bode H, Crawford J, Danon M. Disorders of antidiuretic hormone homeostasis: diabetes insipidus and SIADH. In: Lifshitz F, ed. Pediatric Endocrinology. 1st ed. New York: Marcel Dekker; 1996. p.731-52.
11. Maghnie M, Cosi G, Genovese E, et al. Central diabetes insipidus in children and young adults. N Engl J Med. 2000;343:998-1007. [Crossref]  [PubMed] 
12. Closson BL, Beck LA, Swift MA. Diabetes insipidus and spinal cord injury: a challenging combination. Rehabil Nurs. 1993;18:368-74. [Crossref]  [PubMed] 
13. Farrell CA, Staas WE Jr. Diabetes insipidus in a quadriplegic patient. Arch Phys Med Rehabil. 1986;67:132-4. [Crossref]  [PubMed] 
14. McKinley WO, Gittler MS, Kirshblum SC, et al. Spinal cord injury medicine. 2. Medical complications after spinal cord injury: Identification and management. Arch Phys Med Rehabil. 2002;83:S58-64, S90-8. [Crossref]  [PubMed] 
15. Berezin M, Ohry A, Shemesh Y, et al. Hyperprolactinemia, galactorrhea and amenorrhea in women with a spinal cord injury. Gynecol Endocrinol. 1989;3:159-63. [Crossref]  [PubMed] 
16. Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976). 2001;26:S2-12. [Crossref]  [PubMed] 
17. Rowland JW, Hawryluk GW, Kwon B, et al. Current status of acute spinal cord injury pathophysiology and emerging therapies: promise on the horizon. Neurosurg Focus. 2008;25:E2. [Crossref]  [PubMed] 
18. Oyinbo CA. Secondary injury mechanisms in traumatic spinal cord injury: a nugget of this multiply cascade. Acta Neurobiol Exp (Wars). 2011;71:281-99. [Crossref]  [PubMed] 
19. Tran AP, Warren PM, Silver J. The biology of regeneration failure and success after spinal cord injury. Physiol Rev. 2018;98:881-917. [Crossref]  [PubMed]  [PMC] 
20. Dyck SM, Karimi-Abdolrezaee S. Chondroitin sulfate proteoglycans: key modulators in the developing and pathologic central nervous system. Exp Neurol. 2015;269:169-87. [Crossref]  [PubMed] 
21. Sidhu GS, Ghag A, Prokuski V, et al. Civilian gunshot injuries of the spinal cord: a systematic review of the current literature. Clin Orthop Relat Res. 2013;471:3945-55. [Crossref]  [PubMed]  [PMC] 
22. Mirovsky Y, Shalmon E, Blankstein A, et al. Complete paraplegia following gunshot injury without direct trauma to the cord. Spine (Phila Pa 1976). 2005;30:2436-8. [Crossref]  [PubMed] 
23. Capatina C, Paluzzi A, Mitchell R, et al. Diabetes Insipidus after Traumatic Brain Injury. J Clin Med. 2015;4:1448-62. [Crossref]  [PubMed]  [PMC] 
24. Sandean D. Management of acute spinal cord injury: a summary of the evidence pertaining to the acute management, operative and non-operative management. World J Orthop. 2020;11:573-83. [Crossref]  [PubMed]  [PMC] 
25. Christ-Crain M. EJE AWARD 2019: new diagnostic approaches for patients with polyuria polydipsia syndrome. Eur J Endocrinol. 2019;181:R11-R21. [Crossref]  [PubMed]  [PMC] 
26. Adams NC, Farrell TP, O'Shea A, et al. Neuroimaging of central diabetes insipidus-when, how and findings. Neuroradiology. 2018;60:995-1012. [Crossref]  [PubMed] 
27. Machiedo G, Bolanowski PJ, Bauer J, et al. Diabetes insipidus secondary to penetrating thoracic trauma. Ann Surg. 1975;181:31-4. [Crossref]  [PubMed]  [PMC] 
28. Wilson RH, Whiteside MC, Moorehead RJ. Problems in diagnosis and management of hypovolaemia in spinal injury. Br J Clin Pract. 1993;47:224-5. [Crossref]  [PubMed] 
29. Holly LT, Kelly DF, Counelis GJ, et al. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg. 2002;96:285-91. [Crossref]  [PubMed] 
30. Kiboi J, Omar A, Omar MA. Head injury with concurrent cervical spine injury. Annals of African Surgery. 2019;16. [Crossref]