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Neurocritical Care
Published in: Neurocritical Care 3/2013

01-06-2013 | Review Article

Hyponatremia and Brain Injury: Historical and Contemporary Perspectives

Authors: Matthew A. Kirkman, Angelique F. Albert, Ahmed Ibrahim, Doris Doberenz

Published in: Neurocritical Care | Issue 3/2013

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Abstract

Hyponatremia is common in neurocritical care patients and is associated with significant morbidity and mortality. Despite decades of research into the syndrome of inappropriate antidiuretic hormone (SIADH) and cerebral salt wasting (CSW), their underlying pathophysiological mechanisms are still not fully understood. This paper reviews the history behind our understanding of hyponatremia in patients with neurologic injury, including the first reports of CSW and SIADH, and current and future challenges to diagnosis and management in this setting. Such challenges include distinguishing CSW, SIADH, and hypovolemic hyponatremia due to a normal pressure natriuresis from the administration of large volumes of fluids, and hyponatremia due to certain medications used in the neurocritical care population. Potential treatments for hyponatremia include mineralocorticoids and vasopressin 2 receptor antagonists, but further work is required to validate their usage. Ultimately, a greater understanding of the pathophysiological mechanisms underlining hyponatremia in neurocritical care patients remains our biggest obstacle to optimizing patient outcomes in this challenging population.
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Metadata
Title
Hyponatremia and Brain Injury: Historical and Contemporary Perspectives
Authors
Matthew A. Kirkman
Angelique F. Albert
Ahmed Ibrahim
Doris Doberenz
Publication date
01-06-2013
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 3/2013
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-012-9805-y

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