Cerebral oedema with coning in diabetic keto-acidosis. Report of 2 survivors
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Two children presented with a first episode of diabetic keto-acidosis. Initially both patients made a good clinical and biochemical recovery, but suddenly developed neurological signs consistent with a diagnosis of tentorial herniation. Cranial computed tomography showed signs of cerebral oedema in both cases with evidence of uncal and tentorial herniation in 1 patient, which resolved after the appropriate treatment. The excellent neurological outcome emphasises the need for early recognition and treatment of sudden onset brain oedema in diabetic keto-acidosis.
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