Cerebral edema is a potentially serious complication of diabetic ketoacidosis (DKA).
Risk factors:
(1) delay in the diagnosis of DKA
(2) excessive fluid therapy (overhydration)
(3) pH < 7.1 at presentation
(4) fluid refractory shock
(5) increased serum BUN (azotemia) at presentation
(6) pediatric age group
(7) need for mechanical ventilation
(8) lack of expected rise in serum sodium during resuscitation
(9) severe hyperosmolarity at presentation
Clinical features may include:
(1) headache
(2) vomiting
(3) lethargy
(4) stupor or coma
Complications:
(1) cerebellar tonsillar herniation
