Cerebral Salt-Wasting Syndrome in Subarachnoid Hemorrhage: A Primer for Interventional Neuroradiologists

Adhithyan Rajendran; Santhosh Kumar Kannath; Smitha Vimala; Jayadevan Enakshy Rajan

doi:10.1055/s-0037-1609047

Journal of Clinical Interventional Radiology ISVIR, Table of Contents

CC-BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2018; 02(01): 051-054
DOI: 10.1055/s-0037-1609047

Case Report

Thieme Medical and Scientific Publishers Private Ltd.

Cerebral Salt-Wasting Syndrome in Subarachnoid Hemorrhage: A Primer for Interventional Neuroradiologists

Adhithyan Rajendran

¹Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

,

Santhosh Kumar Kannath

²Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

,

Smitha Vimala

³Department of Neuro-anaesthesia, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

,

Jayadevan Enakshy Rajan

²Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

› Author Affiliations

Abstract

Hyponatremia due to several causes could occur in subarachnoid hemorrhage (SAH), and cerebral salt-wasting syndrome (CSWS) is one of the frequent causes of hyponatremia in this clinical setting. Appropriate clinical diagnosis is important as the treatment is entirely different in various etiologies. In the present report, the authors highlight various clinical and biochemical parameters that help in the recognition of CSWS and discuss its clinical management using a clinical prototype. As neurointerventional radiologists are becoming increasingly involved in the management of intra-cranial aneurysms and SAH, awareness of this entity and its appropriate management is essential in providing optimal care to these patients.

Keywords

basilar top aneurysm - electrolyte imbalance - salt wasting

Full Text

References

References
1 Palmer BF. Hyponatraemia in a neurosurgical patient: syndrome of inappropriate antidiuretic hormone secretion versus cerebral salt wasting. Nephrol Dial Transplant 2000; 15 (02) 262-268
2 Verbalis JG, Goldsmith SR, Greenberg A. et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 2013; 126 (10) Suppl 1) S1-S42
3 Kao L, Al-Lawati Z, Vavao J, Steinberg GK, Katznelson L. Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage. Pituitary 2009; 12 (04) 347-351
4 See AP, Wu KC, Lai PM, Gross BA, Du R. AP. Risk factors for hyponatremia in aneurysmal subarachnoid hemorrhage. J Clin Neurosci 2016; 32: 115-118
5 Momi J, Tang CM, Abcar AC, Kujubu DA, Sim JJ. Hyponatremia—what is cerebral salt wasting?. Perm J 2010; 14 (02) 62-65