Hyponatremia in neurological patients: cerebral salt wasting versus inappropriate antidiuretic hormone secretion.
OBJECTIVE
To assess whether hyponatremia in acute neurological patients is associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or with the cerebral salt-wasting syndrome (CSWS).


METHODS
Clinical, controlled, prospective study.


METHODS
Department of intensive care of a tertiary care academic hospital.


METHODS
Forty acute neurological patients with hyponatremia suggesting SIADH or CSWS (20) or with normonatremia (20).


METHODS
None.


RESULTS
Measurement of clinical and biological variables. Measurement of blood, plasma, and red blood cell volumes to discriminate SIADH and CSWS. Renal, adrenal and thyroid functions were normal in all patients. Average blood, plasma, and red blood cell volumes were 54, 37 and 17ml/kg in control patients and 54, 37 and 18ml/kg in hyponatremic patients, respectively.


CONCLUSIONS
The adequate blood volumes in hyponatremic patients confirm the diagnosis of SIADH and do not support the concept of CSWS.
Brimioulle
Serge
S
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Lennik Road 808, 1070 Brussels, Belgium. serge.brimioulle@ulb.ac.be
Orellana-Jimenez
Carlos
C
Aminian
Adel
A
Vincent
Jean-Louis
JL
D000328:Adult; D000368:Aged; D001923:Brain Chemistry; D001928:Brain Diseases, Metabolic / Q000378:metabolism*; D001930:Brain Injuries / Q000378:metabolism; D002986:Clinical Trials as Topic; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000503:physiopathology*; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012964:Sodium / Q000378:metabolism*; D014883:Water-Electrolyte Imbalance / Q000378:metabolism*
D012964:Sodium