Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ====== Hyponatremia after traumatic brain injury ====== [[Hyponatremia]] is frequent in patients suffering from [[traumatic brain injury]], [[subarachnoid hemorrhage]], or following [[intracranial]] [[procedure]]s, with approximately 20% having a decreased serum [[sodium]] concentration to <125 mmol/L. The [[pathophysiology]] of hyponatremia in neurotrauma is not completely understood, but in large part is explained by the syndrome of inappropriate secretion of [[antidiuretic hormone]] ([[SIADH]]). The abnormal water and/or sodium handling creates an osmotic gradient promoting the shift of water into brain cells, thereby worsening [[cerebral edema]] and precipitating neurological deterioration. Unless hyponatremia is corrected promptly and effectively, [[morbidity]] and [[mortality]] increases through [[seizure]]s, elevations in [[intracranial pressure]], and/or [[herniation]]. The excess mortality in patients with severe [[hyponatremia]] (<125 mmol/L) extends beyond the time frame of hospital [[admission]], with a reported [[mortality]] of 20% in hospital and 45% within 6 months of follow-up. Current options for the management of [[hyponatremia]] include fluid restriction, [[hypertonic saline]], [[mineralocorticoid]]s, and osmotic diuretics. However, the recent development of [[vasopressin]] receptor antagonists provides a more physiological tool for the management of excess water retention and consequent hyponatremia, such as occurs in [[SIADH]] ((Kleindienst A, Hannon MJ, Buchfelder M, Verbalis JG. Hyponatremia in Neurotrauma: The Role of Vasopressin. J Neurotrauma. 2016 Apr 1;33(7):615-24. doi: 10.1089/neu.2015.3981. Epub 2015 Dec 23. Review. PubMed PMID: 26472056. )). hyponatremia_after_traumatic_brain_injury.txt Last modified: 2024/06/07 02:51by 127.0.0.1