Abstract
Background: Hyponatremia is a common complication after aneurysmal subarachnoid hemorrhage (aSAH).
Previous studies have reported an association between hyponatremia and vasospasm,
however whether hyponatremia directly contributes to the pathogenesis of cerebral
vasospasm (CVS), or is a by-product is still unclear. The aim of this study was to
explore an association between hyponatremia and CVS after aSAH, and evaluating the
temporality of these 2 events. Methods: A retrospective study of consecutive patients with aSAH admitted to the Baylor St.
Luke's Medical center between January 2008 and December 2012 was conducted. Demographics,
baseline characteristics, serum sodium levels, and evidence of vasospasm detected
by transcranial Doppler, CT Angiogram, MR angiogram, and digital subtracted angiography
were collected. Patients were dichotomized into a hyponatremic and a normonatremic
group. CVS incidence and clinical outcome was compared between groups. Timing of CVS
after initial hyponatremia episodes was recorded Results: One hundred and sixty 4 patients with aSAH were included. Hyponatremia was identified
in 66 patients (40.2%) and CVS occurred in 71 subjects (43.2%). The incidence of CVS
was higher in the hyponatremic group compared to the normonatremic group, 65.1 % versus
28.5%, respectively (P < .001). Hyponatremia preceded CVS by median 1.5 days suggesting a temporal trend.
Conclusions: Our study shows a significant association between hyponatremia and CVS, with hyponatremia
preceding CVS events. This retrospective finding denotes the need for larger prospective
studies, aiming to clarify the temporal relationship of serum sodium levels and CVS.
Key Words
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Article info
Publication history
Published online: March 20, 2020
Accepted:
February 24,
2020
Received in revised form:
February 19,
2020
Received:
January 28,
2020
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104789
Copyright
© 2020 Elsevier Inc. All rights reserved.
