Preview

Creative surgery and oncology

Advanced search

Hyponatremia in Neurosurgical Patients

https://doi.org/10.24060/2076-3093-2024-14-4-382-387

Abstract

Hyponatremia refers to a common and potentially dangerous electrolyte imbalance observed in neurosurgical patients, particularly following traumatic brain injuries, subarachnoid hemorrhages, brain tumors, and pituitary surgeries. The paper discusses primary causes and pathophysiology of hyponatremia, including the syndrome of inappropriate secretion of antidiuretic hormone, central adrenal insufficiency, and cerebral salt wasting syndrome. The paper presents differential diagnostic approaches for accurately identifying the underlying causes of hyponatremia, as well as therapeutic strategies that include hypertonic sodium solution infusions, hydrocortisone replacement therapy, and the use of vasopressin receptor antagonists. The study delineates the potential complications associated with overly rapid correction of sodium levels, such as osmotic demyelination syndrome. It emphasizes the importance of accurate diagnosis and timely treatment to enhance patient outcomes and minimize the risk of complications.

About the Authors

О. A. Beylerli
Central Research Laboratory, Bashkir State Medical University
Russian Federation

Ozal A. Beylerli — Cand. Sci. (Med.), Senior Researcher

Ufa



A. A. Bukhvostov
N.I. Pirogov Russian National Research Medical University
Russian Federation

Alexander A. Bukhvostov — Cand. Sci. (Biol.), Assoc. Prof., Department of Medical Nanobiotechnology, Faculty of Biomedical

Moscow



References

1. Hannon M.J., Crowley R.K., Behan L.A., O’Sullivan E.P., O’Brien M.M., Sherlock M., et al. Acute glucocorticoid deficiency and diabetes insipidus are common after acute traumatic brain injury and predict mortality. J Clin Endocrinol Metab. 2013;98(8):3229–37. DOI: 10.1210/jc.2013-1555

2. Hannon M.J., Finucane F.M., Sherlock M., Agha A., Thompson C.J. Clinical review: Disorders of water homeostasis in neurosurgical patients. J Clin Endocrinol Metab. 2012;97(5):1423–33. DOI: 10.1210/jc.2011-3201

3. Sherlock M., O’Sullivan E., Agha A., Behan L.A., Rawluk D., Brennan P., et al. The incidence and pathophysiology of hyponatraemia after subarachnoid haemorrhage. Clin Endocrinol (Oxf). 2006;64(3):250–4. DOI: 10.1111/j.1365-2265.2006.02432.x

4. Hannon M.J., Behan L.A., O’Brien M.M., Tormey W., Ball S.G., Javadpour M., et al. Hyponatremia following mild/moderate subarachnoid hemorrhage is due to SIAD and glucocorticoid deficiency and not cerebral salt wasting. J Clin Endocrinol Metab. 2014;99(1):291–8. DOI: 10.1210/jc.2013-3032. Erratum in: J Clin Endocrinol Metab. 2014;99(3):1096.

5. Hannon M.J., Thompson C.J. Hyponatremia in neurosurgical patients. Front Horm Res. 2019;52:143–60. DOI: 10.1159/000493244

6. Azakami K., Miyazaki M. A case of cerebral salt wasting syndrome caused by minor head injury. Nihon Ronen Igakkai Zasshi. 2019;56(1):67–73. DOI: 10.3143/geriatrics.56.67

7. Poch E., Molina A., Piñeiro G. Syndrome of inappropriate antidiuretic hormone secretion. Med Clin (Barc). 2022;159(3):139–46. DOI: 10.1016/j.medcli.2022.02.015

8. Sterns R.H., Rondon-Berrios H., Adrogué H.J., Berl T., Burst V., Cohen D.M., et al. Treatment guidelines for hyponatremia: stay the course. Clin J Am Soc Nephrol. 2024;19(1):129–35. DOI: 10.2215/CJN.0000000000000244

9. Seifter J.L. Body fluid compartments, cell membrane ion transport, electrolyte concentrations, and acid-base balance. Semin Nephrol. 2019;39(4):368–79. DOI: 10.1016/j.semnephrol.2019.04.006

10. Spasovski G. Hyponatraemia-treatment standard 2024. Nephrol Dial Transplant. 2024;39(10):1583–92. DOI: 10.1093/ndt/gfae162

11. Hoorn E.J., Lindemans J., Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant. 2006;21(1):70–6. DOI: 10.1093/ndt/gfi082


Review

For citations:


Beylerli О.A., Bukhvostov A.A. Hyponatremia in Neurosurgical Patients. Creative surgery and oncology. 2024;14(4):382-387. (In Russ.) https://doi.org/10.24060/2076-3093-2024-14-4-382-387

Views: 463


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2076-3093 (Print)
ISSN 2307-0501 (Online)