[Does cerebral salt wasting syndrome exist?]

Ann Fr Anesth Reanim. 2007 Nov;26(11):948-53. doi: 10.1016/j.annfar.2007.08.005. Epub 2007 Nov 1.
[Article in French]

Abstract

Increased natriuresis is a frequent situation after subarachnoid haemorrhage (SAH). It may be responsible for hyponatremia, which can be dangerous in case of severe hypo-osmolarity or hypovolemia. Inappropriate secretion of antidiuretic hormone or cerebral salt wasting syndrome (CSWS) have been incriminated for hyponatremia after SAH, but it remains difficult to distinguish between both syndromes. There are many explanations for increased natriuresis after SAH, depending on the level of blood pressure, the volemia, and the presence or not of natriuretic peptides. The cerebral insult and the treatments, which are done to fight against elevated intracranial pressure or vasospasm, can modify any of these parameters. So it appears that the word "cerebral" in CSWS is probably not a good term and it would be better to talk about appropriate or non-appropriate natriuretic response. Corticoïds or urea can be useful for controlling hypernatriuresis.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Blood Pressure
  • Brain Diseases / drug therapy
  • Brain Diseases / epidemiology
  • Brain Diseases / etiology*
  • Brain Diseases / physiopathology
  • Diagnosis, Differential
  • Humans
  • Hyponatremia / drug therapy
  • Hyponatremia / epidemiology
  • Hyponatremia / physiopathology*
  • Hypovolemia / drug therapy
  • Hypovolemia / epidemiology
  • Hypovolemia / physiopathology*
  • Inappropriate ADH Syndrome / drug therapy
  • Inappropriate ADH Syndrome / epidemiology
  • Inappropriate ADH Syndrome / physiopathology
  • Incidence
  • Natriuresis*
  • Urea / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Urea