Türk Nöroşirürji Dergisi 2006 , Vol 16 , Num 3
Hyponatremia Following Aneurysmal Subarachnoidal Hemorrhage
Ayhan TEKİNER, M. Akif BAYAR, Ömer ŞAHİN, Celal KILIÇ, Cevdet GÖKÇEK, Yavuz ERDEM, Nurullah EDEBALİ, Uğur YAŞITLI, Haydar ÇELİK, Mete KARATAY
Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi Nöroşirürji Kliniği, Ankara OBJECTIVE: To investigate the relationship of hyponatremia developing with aneurysmal subarchnoidal hemorrhage with clinical and angiographic vasospasm and also with morbidity and mortality.

METHODS: One hundred cases hospitalised for spontaneously subarachnoidal hemorrhage before determining intracranial aneursym with anjiographia were evaluated retrospectively. Serum Na level was evaluated using ion selective electron method. Saito's angiographic vasospasm classification was used to evaluate angiographic vasospasm.

RESULTS: In this study, the relationship between hiponatremia and localisation of aneurym, vasospasm, mortality- morbidity and the time of hemorrhage was evaluated. Hyponatremia was more freguently observed an aneurysms of anterior and middle cerbellar arter in our study. Clinical vasospasm was 23 % and angiographic vasospasm was 59 %. There was a direct relation between the amount of hemorrhage on CT and angiographic vasospasm. Seventy percentage of the angiographic vasospasm was Fisher degree 3 and 4. In this study, hyponatremia developed in 27 of 100 cases(27 %) and the mortality was 30,8 % for these cases. The period of formation of hyponatremia was 9 days and this was in accordance with the literature.

CONCLUSION: Hyponatremia is a frequent complication of aneurismal subarachnoidal hemorrhage. Cases with hiponatremia have a a higher risk of cerebral infactus, morbidity and mortality than cases with optimal plasma Na level. For this reason daily serum Na level must be evaluated on subarachnoidal hemorrhage cases with aneursym on angiography. Anahtar Kelimeler : Subaracnoidal hemorrhage, Hyponatremia