An Integrative Review of Cerebral Salt Wasting Syndrome

Cerebral salt wasting syndrome in a patient who suffered a gunshot traumatic head injury: a case report

Cerebral salt wasting syndrome is described as a hyponatremic condition in the context of a central nervous system injury. It is caused by a renal loss of sodium, and the primary distinguishing factor among similar conditions, such as the syndrome of inappropriate antidiuretic hormone secretion, is a reduction in the extracellular fluid volume. We describe here the case of a young adult who suffered brain injuries as a result of a gunshot and developed cerebral salt wasting syndrome during his in-hospital stay. Any type of cerebral attack can lead to hyponatraemic syndrome, but the most common are subarachnoid hemorrhages and neurological and meningeal tuberculosis infections. Treatment of the cerebral salt wasting syndrome leads to both hypovolemia and hyponatremia correction. The first line of management included hydric reposition with saline solution, either isotonic or hypertonic, depending on the severity of the symptoms.

Hyperlactatemia and other perioperative metabolic disturbances in neuroanesthesia

PURPOSE OF REVIEW

The concept of 'brain-body cross-talking' has gained growing interest in the last years. The understanding of the metabolic disturbances (e.g., hypernatraemia/hyponatraemia and hyperlactatemia) in neurosurgical patients has improved during the last years.

RECENT FINDINGS

The impact of elevated lactate without acidosis in neurosurgical patients remains controversial. The pathophysiology of inappropriate secretion of antidiuretic hormone (SIADH) has become clearer, whereas the diagnosis of cerebral salt wasting should be used more carefully.

SUMMARY

These findings will contribute to a better understanding of the pathophysiology involved and enable better prevention and therapy where possible in clinical practice.