Abstract
Objectives
Vasospasm is a well-known complication of aneurysmal subarachnoid hemorrhage (aSAH)
that generally occurs 4–14 days post-hemorrhage. Based on American Heart Association
guidelines, the current understanding is that hyponatremic episodes may lead to vasospasm.
Therefore, we sought to determine the association between repeated serum sodium levels
of aSAH patients and its relationship to radiographic vasospasm.
Materials and methods
A single-center retrospective analysis from 2007–2016 was conducted of aSAH patients.
Daily serum sodium levels were recorded up to day 14 post-admission. Hyponatremia
was defined as a serum sodium value of < 135 mEq/L. We evaluated the relationship
to radiologic vasospasm, neurologic deterioration, functional status at discharge,
and mortality. A repeated measures analysis using a mixed-effect regression model
was performed to assess the interindividual relationship between serum sodium trends
and outcomes.
Results
A total of 271 aSAH patients were included. There were no significant differences
in interindividual serum sodium values over time and occurrence of radiographic vasospasm,
neurologic deterioration, functional, or mortality outcomes (p = .59, p = .42, p = .94, p = .99, respectively) using the mixed-effect regression model. However, overall mean
serum sodium levels were significantly higher in patients who had neurologic deterioration,
poor functional outcome (mRS 3-6), and mortality.
Conclusions
Serum sodium level variations are not associated with subsequent development of cerebral
vasospasm in aSAH patients. These findings indicate that serum sodium may not have
an impact on vasospasm, and avoiding hypernatremia may provide a neurologic, functional
and survival benefit.
Key Words
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Article info
Publication history
Published online: November 05, 2021
Accepted:
October 13,
2021
Received in revised form:
October 11,
2021
Received:
July 11,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106186
Copyright
© 2021 Elsevier Inc. All rights reserved.
