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Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: Is fluid restriction harmful?
Author(s) -
Wijdicks E. F. M.,
Vermeulen M.,
Hijdra A.,
van Gijn J.
Publication year - 1985
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410170206
Subject(s) - hyponatremia , medicine , fluid restriction , subarachnoid hemorrhage , antidiuretic , cerebral infarction , syndrome of inappropriate antidiuretic hormone secretion , anesthesia , infarction , cardiology , ischemia , myocardial infarction , hormone
We studied retrospectively the relationship between hyponatremia and cerebral infarction in 134 consecutive patients with aneurysmal subarachnoid hemorrhage. In 44 patients sodium levels fell below 135 mmol/L on at least two consecutive days between the second and the tenth day after the hemorrhage. Twenty‐five of these patients fulfilled the criteria for the syndrome of inappropriate secretion of antidiuretic hormane. Cerebral infarction developed in 27 of the 44 patients with hyponatremia and in 19 of the 90 patients with normal serum sodium levels (p < 0.001). Cerebral infarctions were more often fatal in patients with hyponatremia (p < 0.01). Twenty‐six of the 44 patients had been treated with fluid restriction to correct the serum sodium levels, and infarctions developed in 21. Fluid restriction to correct hyponatremia appears to be potentially dangerous in patients with aneurysmal subarachnoid hemorrhage.