How do you manage cerebral salt wasting?

How do you manage cerebral salt wasting?

Management of cerebral salt-wasting syndrome centers on correction of intravascular volume depletion and hyponatremia, as well as on replacement of ongoing urinary sodium loss, usually with intravenous (IV) hypertonic saline solutions.

What is salt-wasting syndrome?

Cerebral salt wasting syndrome (CSW) is defined as a renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The pathogenesis of this disorder is still not completely understood.

How does low sodium affect the brain?

In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death. Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage.

Can a brain tumor cause low sodium?

Acute onset hyponatremia is particularly common in patients who have undergone any type of brain insult, including traumatic brain injury, subarachnoid hemorrhage and brain tumors, and is a frequent complication of intracranial procedures.

How do you differentiate CSW and SIADH?

Response to fluid therapy is also a key distinction between SIADH and CSW. The treatment of choice for SIADH is free water restriction when increased fluid intake will worsen the hyponatremia. In contrast, CSW is a volume-depleted and sodium-wasting state requiring fluid replacement with isotonic solutions.

Does cerebral salt wasting cause polyuria?

Highlights: Cerebral salt wasting is a complication of aneurysmal subarachnoid hemorrhage. Refractory Polyuria due to ADH dysregulation can coexist with cerebral salt wasting.

Can low sodium levels cause permanent brain damage?

Hyponatremia is a very common electrolyte disorder, especially in the elderly. The consequences of hyponatremia, in particular when acute, on the brain may be clinically evident and severe, including permanent disability or death.

What cancers cause low sodium levels?

Hyponatremia is commonly seen in patients with lung, head and neck, gastrointestinal, breast, kidney cancers and lymphoma. Hyponatremia is caused by disequilibrium between body salt and water; either from loss of body salt or from relative or absolute excess of body water.

Is it cerebral or renal salt-wasting?

Cerebral salt-wasting (CSW), or renal salt-wasting (RSW), has evolved from a misrepresentation of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) to acceptance as a distinct entity.