scholarly journals Delayed Postoperative Hyponatremia Following Endoscopic Transsphenoidal Surgery for Non-Adenomatous Parasellar Tumors

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3849
Author(s):  
Hirotaka Hasegawa ◽  
Masahiro Shin ◽  
Noriko Makita ◽  
Yuki Shinya ◽  
Kenji Kondo ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Transsphenoidal Surgery ◽  
Hormone Secretion ◽  
Underlying Mechanism ◽  
Endoscopic Transsphenoidal Surgery ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
The Mean ◽  
Postoperative Hyponatremia

Little is known about delayed postoperative hyponatremia (DPH) accompanied with transsphenoidal surgery for non-adenomatous skull base tumors (NASBTs). Consecutive data on 30 patients with parasellar NASBT was retrospectively reviewed with detailed analyses on perioperative serial sodium levels. Serological DPH (sodium ≤ 135 mmol/L) was observed in eight (27%), with four (13%) of them being symptomatic. DPH developed on postoperative day 7–12 where the mean sodium levels were 134 mmol/L (a mean of 7 mmol/L drop from the baseline) in asymptomatic and 125 mmol/L (a mean of 17.5 mmol/L drop from the baseline) in symptomatic DPH. Serological DPH was accompanied with “weight loss and hemoconcentration (cerebral salt wasting type)” in four (50%), “weight gain and hemodilution (syndrome of inappropriate antidiuretic hormone secretion type)” in three (38%), and no significant weight change in one. Intraoperative extradural retraction of the pituitary gland was the only significant factor for serological DPH (p = 0.035; odds ratio, 12.25 (95% confidence interval, 1.27–118.36)). DPH should be recognized as one of the significant postsurgical complications associated with TSS for NASBTs. Although the underlying mechanism is still controversial, intraoperative extradural compression of the pituitary gland and subsequent dysregulation of the hypothalamo-hypophyseal axis may be responsible.

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Visual Disturbance ◽  
Mental Condition ◽  
Microcirculatory Disturbance ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting

Abstract Background: Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Case report: A 60-year-old patient was admitted to the emergency room with pain in the upper abdomen and visual disturbance two weeks after knee replacement. The patient was confused with severe hematoma at the site of the knee endoprosthesis. Laboratory values showed massive thrombocytosis, leukocytosis, anemia, severe hyponatremia and no evidence of infection. CT scan of the abdomen was inconspicuous. Head MRI showed no ischemia or bleeding, but a mild microangiopathy. A myeloproliferative neoplasm (MPN) was suspected and confirmed by bone marrow biopsy. Cerebral salt wasting syndrome was identified as the cause of severe hyponatremia most likely provoked by cerebral microcirculatory disturbance. The hematoma at the operation site was interpreted as a result of a secondary von Willebrand syndrome (vWS) due to the myeloproliferative neoplasm with massive thrombocytosis. After starting cytoreductive therapy with hydroxycarbamide, thrombocytosis and blood sodium slowly improved along with normalization of his mental condition. Conclusion: To the best of our knowledge this is the first description of a patient with CSW most likely caused by a microcirculatory disturbance due to a massive thrombocytosis in the context of a myeloproliferative neoplasm.

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Cerebral Hematoma ◽  
Very High ◽  
Rare Metabolic Disorder

Abstract Background Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Cerebral Hematoma ◽  
Very High ◽  
Rare Metabolic Disorder

Abstract Background Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Subarachnoid Hemorrhage

2018 ◽  
pp. 44-53
Author(s):  
Sherry Hsiang-Yi Chou
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Complex Disease ◽  
Hormone Secretion ◽  
Delayed Cerebral Ischemia ◽  
Early Brain Injury ◽  
Neurogenic Pulmonary Edema ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Wasting Syndrome

Subarachnoid hemorrhage (SAH) affects over 30,000 Americans per year, leaves over half of its survivors in severe disability, and has a mortality rate of approximately 20%. SAH syndrome presents with a complex disease course and symptoms involving both the central nervous system (CNS) as well as extra-CNS systems. SAH may lead to early brain injury, cerebral vasospasm, and delayed cerebral ischemia, which increases SAH morbidity and mortality. SAH-related extra-CNS organ injuries include neurogenic stunned myocardium, neurogenic pulmonary edema, syndrome of inappropriate antidiuretic hormone secretion, cerebral salt wasting syndrome, systemic inflammatory response syndrome, fever, and venous thromboembolism, all of which require careful critical care management. Though multiple randomized trials in the recent years have not successfully identified any effective neuroprotective therapy in SAH, the overall SAH outcome has significantly improved over the past two decades.

scholarly journals Syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting as the common causes of hyponatremia in tertiary care hospital

2020 ◽  
Vol 7 (4) ◽  
pp. 577
Author(s):  
Yogesh Pralhad Bade ◽  
Harishchandra Rameshchandra Chaudhari
Keyword(s):  
Antidiuretic Hormone ◽  
Tertiary Care ◽  
Hormone Secretion ◽  
Cerebral Salt Wasting ◽  
Common Cause ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Antidiuretic Hormone Secretion ◽  
Common Causes ◽  
The Common

Background: Hyponatremia is a typical condition of electrolyte disturbance that may be euvolemic, hypovolemic or hypervolemic. Proper interpretation through laboratory tests helps to differentiate the types and causes of hyponatremia. This study was conducted to evaluate the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW) as the common causes of hyponatremia in tertiary care hospital.Methods: A prospective interventional study was conducted, including hyponatremia cases, admitted in NTU/ICU/CCU and other medical wards at Ruby Hall Clinic from August 2011 to December 2013.Results: Of 150 patients enrolled in this study, 33.33% patients were euvolemic, 34% patients were hypervolemic and 32.66% patients were hypovolemic. For the euvolemic patients, SIADH (68%) was the most common cause; whereas, CSW (34.39%) was the common cause for hypovolemic type of hyponatremia. Stroke was found to be the most common cause of SIADH (55.88%), Intra-cerebral bleeding was observed to be the most common causative factor between SIADH and CSW associated hyponatremia.Conclusions: Hyponatremia in central nervous system disorder patients frequently occurred due to SIADH and CSW. Most common cause of SIADH was stroke and for CSW it was intra cerebral bleed.

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