Clinical analysis of the syndrome of inappropriate antidiuretic hormone secretion after brain injury.
OBJECTIVE
To study the diagnosis and treatment of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) after brain injury.


METHODS
A retrospective analysis was conducted on 12 patients suffered from SIADH after brain injury. The clinical features of these patients were similar to those of common hyponatremia. Most of the hyponatremia were detected by routine examinations. Supplement of salt as the initial treatment was used in these patients. If natremia did not rise or descended 2-3 days after treatment, SIADH was considered or diagnosed. Treatment scheme should be adjusted to limit water and natrium instead of supplying salt. Frusemide and albumin were the first choice for dehydration therapy.


RESULTS
24-48 hours after limiting water and natrium, 12 patient's natremia level was back to normal. Eight out of 12 patients were corrected completely in 1 week, 1 in 14 days, and 1 in 3 months after injury.


CONCLUSIONS
Diagnosis of SIADH is difficult before treatment though effective treatment can be obtained if we adopt correct strategy. In these patients, the diagnosis of SIADH is confirmed in the course of treatment.
Cai
Jia-ning
JN
Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China. jianin@pub.guangzhou.gd.cn
Wang
Guo-liang
GL
Yi
Jun
J
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000150:complications*; D007177:Inappropriate ADH Syndrome / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012964:Sodium / Q000627:therapeutic use; D014867:Water / Q000008:administration & dosage
D014867:Water; D012964:Sodium