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Published byDomenic Wilkinson Modified over 6 years ago
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A dorsal view of the brain shows severe brain swelling with flattened gyri and effaced sulci. Evidence of brain swelling with herniation was seen on the brain’s ventral surface. Pretreatment brain herniation is rare, but brain swelling prior to treatment (incompletely understood cause[s]) appears common among pediatric patients with DKA. This 17-year-old known diabetes patient collapsed at home and developed hypertension, bradycardia, and agonal respirations on arrival of first responders. Such patients underscore the need for careful volume resuscitation, fluid and electrolyte management, and timely administration of insulin in those with DKA, because they likely present with some degree of brain swelling even before treatment begins. (Photo contributor: M.G.F. Gilliland, MD.) Source: Chapter 14. Endocrinology, Atlas of Pediatric Emergency Medicine, 2e Citation: Shah BR, Lucchesi M, Amodio J, Silverberg M. Atlas of Pediatric Emergency Medicine, 2e; 2013 Available at: Accessed: October 09, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved
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