Neurosurgical Hyponatremia

Journal of Clinical Medicine

Mark J. Hannon²  Christopher J. Thompson¹ 

[1] Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin, Ireland; E-Mail:;Department of Endocrinology, St. Bartholomew’s Hospital, London, EC1A 7BE, UK

关键词: hyponatremia;    neurosurgery;    SIADH;    SAH;    TBI;   

DOI  :  10.3390/jcm3041084

来源: mdpi

【 摘 要 】

Hyponatremia is a frequent electrolyte imbalance in hospital inpatients. Acute onset hyponatremia is particularly common in patients who have undergone any type of brain insult, including traumatic brain injury, subarachnoid hemorrhage and brain tumors, and is a frequent complication of intracranial procedures. Acute hyponatremia is more clinically dangerous than chronic hyponatremia, as it creates an osmotic gradient between the brain and the plasma, which promotes the movement of water from the plasma into brain cells, causing cerebral edema and neurological compromise. Unless acute hyponatremia is corrected promptly and effectively, cerebral edema may manifest through impaired consciousness level, seizures, elevated intracranial pressure, and, potentially, death due to cerebral herniation. The pathophysiology of hyponatremia in neurotrauma is multifactorial, but most cases appear to be due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Classical treatment of SIADH with fluid restriction is frequently ineffective, and in some circumstances, such as following subarachnoid hemorrhage, contraindicated. However, the recently developed vasopressin receptor antagonist class of drugs provides a very useful tool in the management of neurosurgical SIADH. In this review, we summarize the existing literature on the clinical features, causes, and management of hyponatremia in the neurosurgical patient.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.