Adipsia is a rare disorder that occurs due to damage to the osmoreceptor and not
feeling thirst despite hyperosmolality. Adipsic
hypernatremia can occur when there is damage to the anterior communicating
artery that
supplies blood to osmoreceptors, and the level of
arginine vasopressin secretion varies widely. A 37-year-old
woman, suffering from severe
headache, was consulted to the
nephrology department for
hypernatremia and
polyuria after clipping of a
ruptured aneurysm in the anterior communicating
artery. Despite her hypernatremic hyperosmolar
state, she denied
thirst and did not drink spontaneously. She was diagnosed adipsic
hypernatremia by evaluating the osmoregulatory and baroregulatory function tests.Because adipsic
hypernatremia is caused by not enough
drinking water even for hyperosmolality due to the lack of
thirst stimulus, the
strategies of
treatment are that setting the target
body weight when
serum osmolality is normal and have the
patient drink
water until
patient reach the target
body weight. Adipsic
hypernatremia should be considered to be a rare complication of
subarachnoid hemorrhage associated with an
anterior communicating artery aneurysm.