Lerner David P, Shepherd Starane A, Batra Ayush
Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA, USA.
Department of Neurology, Rush University Medical Center, Chicago, IL, USA.
Neurohospitalist. 2020 Jul;10(3):208-216. doi: 10.1177/1941874419895124. Epub 2020 Jan 10.
Hyponatremia is a well-known disorder commonly faced by clinicians managing neurologically ill patients. Neurological disorders are often associated with hyponatremia during their acute presentation and can be associated with specific neurologic etiologies and symptoms. Patients may present with hyponatremia with traumatic brain injury, develop hyponatremia subacutely following aneurysmal subarachnoid hemorrhage, or may manifest with seizures due to hyponatremia itself. Clinicians caring for the neurologically ill patient should be well versed in identifying these early signs, symptoms, and etiologies of hyponatremia. Early diagnosis and treatment can potentially avoid neurologic and systemic complications in these patients and improve outcomes. This review focuses on the causes and findings of hyponatremia in the neurologically ill patient and discusses the pathophysiology, diagnoses, and treatment strategies for commonly encountered etiologies.
低钠血症是临床医生在治疗神经系统疾病患者时常见的一种病症。神经系统疾病在急性发作时常常伴有低钠血症,并且可能与特定的神经病因及症状相关。患者可能因创伤性脑损伤出现低钠血症,在动脉瘤性蛛网膜下腔出血后亚急性发生低钠血症,或者可能因低钠血症本身而出现癫痫发作。照料神经系统疾病患者的临床医生应精通识别低钠血症的这些早期体征、症状和病因。早期诊断和治疗有可能避免这些患者出现神经和全身并发症并改善预后。本综述重点关注神经系统疾病患者低钠血症的病因和表现,并讨论常见病因的病理生理学、诊断和治疗策略。