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Cited by 288Electrolyte and hormonal disordersCerebrospinal fluid and hydrocephalusInfectious Encephalopathies and Encephalitis

Epidemiology, pathophysiology, and management of hyponatremic encephalopathy.

Fraser, Cosmo L., Arieff, Allen I.·1997·The American Journal of Medicine
DOI 10.1016/s0002-9343(96)00274-4
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Abstract

Hyponatremia is the most common electrolyte abnormality among hospitalized patients. Death or brain damage associated with hyponatremia has been described since 1935, and it is now evident that hyponatremia can lead to death in otherwise healthy individuals. In the past, it had been assumed that the likelihood of brain damage from hyponatremia was directly related to either a rapid decline in plasma sodium or a particularly low level of plasma sodium. Recent studies have demonstrated that other factors may be more important. These factors include the age and gender of the individual, with children and menstruant women the most susceptible. Although many clinical settings are associated with hyponatremia, those most often associated with brain damage are postoperative, polydipsia, pharmacological agents, and heart failure. Morbidity and mortality associated with hyponatremia are primarily a result of brain edema, hypoxemia, and associated hormonal factors. Management of hyponatremia is largely determined by symptomatology. If the patient is asymptomatic, discontinuation of drugs plus water restriction is often sufficient. If the patient is symptomatic, active therapy to increase the plasma sodium with hypertonic NaCl is usually indicated. Although inappropriate therapy of hyponatremia can lead to brain damage, such an occurrence is rare. Thus, the risk of not treating a symptomatic patient for exceeds that of improper therapy.

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  • Sex hormone effects on body fluid and sodium regulation have important implications for several syndromes that affect women, including orthostatic hypotension, insulin resistance, polycystic ovary syndrome, and neurological consequences of postoperative and exercise-associated hyponatremia.

    “Moreover, the impact of sex hormones on body fluid and sodium regulation has important implications for a number of syndromes for which women are at risk, including orthostatic hypotension, insulin resistance, polycystic ovary syndrome, and neurological consequences from postoperative (8) and exercise-associated hyponatremia (1).”

    From Sex Hormone Effects on Body Fluid Regulation (2008) · cites this paper as [8]

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Authors
Fraser, C. L., & Arieff, A. I.
Affiliations
San Francisco VA Medical Center (US)
Corresponding author
Arieff, Allen I.
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
1997-01
Volume
102
Issue
1
Pages
67-77
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/s0002-9343(96)00274-4
OpenAlex
W2135157479
Cited by
288
References
69
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 11 · 2017: 6 · 2016: 15 · 2015: 15 · 2014: 14 · 2013: 16 · 2012: 13
FWCI
2.37
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ag008575-06)
  • National Institute on Aging (R01-AG-08575)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
hyponatremic encephalopathy, hyponatremia, plasma sodium, cerebral edema, water intoxication, central diabetes insipidus, pulmonary edema, cerebral infarction, coma, pathophysiology, management, epidemiology, water balance, seizures, respiratory arrest, persistent vegetative state, cortical blindness
MeSH terms
Brain Diseases, Metabolic, Diagnosis, Differential, Humans, Hyponatremia

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