Hyponatremia as predictor of symptomatic vasospasm in aneurysmal subarachnoid hemorrhage
Hyponatremia as predictor of symptomatic vasospasm in aneurysmal subarachnoid hemorrhage
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DOI：
10.1016/j.inat.2020.100843
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发表时间：
2020-12-01
影响因子：
0.4
通讯作者：
Al-Qahtani, Shaya Yaanallah
中科院分区：
文献类型：
--
作者：
Alabbas, Faisal;Hadhiah, Kawther;Al-Qahtani, Shaya Yaanallah
背景资料：蛛网膜下腔出血是血管神经科和神经外科的高发病率疾病之一，症状性脑血管痉挛可导致迟发性脑缺血。其他常见的并发症是电解质和体液平衡紊乱，其中包括钠失衡，低钠血症或高钠血症。在我们的机构中，我们观察到低钠血症很常见，在症状性血管痉挛患者中更为明显。为此，我们回顾性地研究了低钠血症与aSAH.Methods中症状性血管痉挛或迟发性脑缺血发生的相关性：回顾性病历回顾，从发作时aSAH的第1天到第21天每天监测钠水平。我们包括所有成人患者（年龄> 18岁），他们被诊断为aSAH并在48小时内接受动脉瘤固定手术。结果：在45例患者中，24例（43%）发生症状性血管痉挛和迟发性脑缺血，男性最常见（13/22：59%）。结论：迟发性脑缺血/症状性脑血管痉挛多发生于男性，且与低钠血症（Na+ < 134）有关，可在发病后第4天预测。
Background: Subarachnoid hemorrhage is one of high morbidity in vascular neurology and neurosurgery and one of the clipart for this is symptomatic vasospasm that can leads to delayed cerebral ischemia. Other common complication is electrolytes and fluid homeostasis disturbance and among these, is Sodium disequilibrium, either hypo- or hypernatremia. In our institution we observed that hyponatremia is common, and it is more evident in patient with symptomatic vasospasm. For that we retrospectively looked at the association of hyponatremia and the occurrence of symptomatic vasospasm or delayed cerebral ischemia in aSAH.Methods: Retrospective chart review with daily monitoring of sodium level from day 1 to day 21 from the ictus, aSAH. We include all adult patients (Age > 18 years) who were admitted to intensive care with diagnosis of aSAH and undergone aneurysm securing procedures within 48 h.Results: Among 45 patients 24 (43%) developed symptomatic vasospasm and delayed cerebral ischemia and it was most common in males (13/22: 59%). Sodium level especially hyponatremia in period between days (1-4) with median of 134 in vasospasm group (50%).Conclusions: Delayed cerebral ischemia/symptomatic vasospasm occurs more commonly in males and associated with hyponatremia (Na+ < 134) and can be predicted in the first 4 days.