title: Clinical review: Disorders of water homeostasis in neurosurgical patients.
abstract: BACKGROUND
  Disorders of water balance are common in neurosurgical patients and usually manifest as hypo- or hypernatremia. They are most commonly seen after subarachnoid hemorrhage, traumatic brain injury, with intracranial tumors, and after pituitary surgery.
  
  
  METHODS
  We reviewed the experience of endocrine evaluation and management of disorders of salt and water balance in a large cohort of inpatients attending the national neurosciences referral centre in Dublin, Ireland, and compared this experience with findings from other studies.
  
  
  METHODS
  The study group included unselected neurosurgical patients admitted to our centre and requiring endocrine evaluation.
  
  
  METHODS
  We conducted investigations to determine the underlying mechanistic basis for disorders of salt and water balance in neurosurgical patients and treatment to restore normal metabolism.
  
  
  METHODS
  Morbidity and mortality associated with deranged salt and water balance were measured.
  
  
  RESULTS
  The underlying pathophysiology of disordered water balance in neurosurgical patients is complex and varied and dictates the optimal therapeutic approach.
  
  
  CONCLUSIONS
  A systematic and well-informed approach is needed to properly diagnose and manage disorders of salt and water balance in neurosurgical patients.
authors.affiliation: Academic Department of Endocrinology, Beaumont Hospital and Royal College of Surgeons in Ireland Medical School, Dublin 9, Ireland.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hannon
authors.forename: Francis M
authors.initials: FM
authors.lastname: Finucane
authors.forename: Mark
authors.initials: M
authors.lastname: Sherlock
authors.forename: Amar
authors.initials: A
authors.lastname: Agha
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Thompson
mesh_terms: D006801:Humans; D009422:Nervous System Diseases / Q000150:complications*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis / Q000209:etiology*