Wijdicks E F, Vandongen K J, Vangijn J, Hijdra A, Vermeulen M
University Department of Neurology, Rotterdam, The Netherlands.
J Neurol Neurosurg Psychiatry. 1988 Apr;51(4):516-20. doi: 10.1136/jnnp.51.4.516.
Hyponatraemia following aneurysmal subarachnoid haemorrhage is associated with an increased risk of cerebral infarction. Whether the development of hyponatraemia was related to enlargement of the third ventricle on the admission CT scan was investigated in a consecutive series of 133 patients who were seen within 72 hours of aneurysmal haemorrhage. Hyponatraemia occurred significantly more often in patients with enlargement of the third ventricle (with or without dilatation of the lateral ventricles) than in patients with a normal ventricular system (20/41 versus 24/92, p = 0.016). After ventricular drainage, the sodium levels returned to normal in two patients in whom the size of the third ventricle decreased and not in four patients with persistent enlargement of the third ventricle. The significant relationship between enlargement of the third ventricle and hyponatraemia remained after adjustment for the amount of cisternal blood, but not after adjustment for the amount of intraventricular blood. These results suggest that the size of the third ventricle is an important but not the only factor in the relationship between acute hydrocephalus and hyponatraemia in patients with aneurysmal subarachnoid haemorrhage.
动脉瘤性蛛网膜下腔出血后低钠血症与脑梗死风险增加相关。在一系列连续的133例动脉瘤性出血后72小时内就诊的患者中，研究了入院CT扫描时低钠血症的发生是否与第三脑室扩大有关。第三脑室扩大（伴或不伴侧脑室扩张）的患者中低钠血症的发生率显著高于脑室系统正常的患者（20/41对24/92，p = 0.016）。脑室引流后，两名第三脑室大小减小的患者血钠水平恢复正常，而四名第三脑室持续扩大的患者血钠水平未恢复正常。调整脑池内出血量后，第三脑室扩大与低钠血症之间的显著关系仍然存在，但调整脑室内出血量后则不存在。这些结果表明，第三脑室大小是动脉瘤性蛛网膜下腔出血患者急性脑积水与低钠血症关系中的一个重要因素，但不是唯一因素。
