| OBJECTIVE : Abnormal serum sodium levels (hyponatremia and hypernatremia) are frequently observed during the acute period after aneurysmal subarachnoid hemorrhage (SAH) and may worsen cerebral edema and mass effect. We performed this study to determine whether the serum sodium concentration abnormalities may cause vasospasm postoperatively and is related to 3-month poor clinical outcome.METHODS : We analyzed retrospectively collected data for the patients who had clipped cerebral aneurysm after aneurismal SAH at China-Japan Hospital at CHangChun. The presence of hypernatremia (serum sodium concentration of >145 mmol/L) and hyponatremia (serum sodium concentration of <135 mmol/L) was determined with serum sodium measurements obtained from admission to 3(We define it as early-serum sodium concentration), from 6 to 9 days after SAH (We define it as late-serum sodium concentration). The effects of hypernatremia and hyponatremia on the risk of symptomatic vasospasm and on 3-month outcomes were analyzed after adjustment for the following potential confounding factors: age, sex, preexisting hypertension, admission Hunt and Hess score, initial mean arterial pressure, subarachnoid clot thickness, intraventricular blood or intraparenchymal hematoma, ventricular dilation, and size of the neck of aneurysm and location.RESULTS : Of 251patients in the analysis, 23(9.2%) developed hypernatremia andl34 (53.3%) developed hyponatremia. Neither hypernatremia nor hyponatremia was significantly associated with poor outcomes or vasospasm postoperatively. A positive correlation was observed between age, vasospasm postoperatively, ventricular dilation , initial mean arterial pressure, initial leukocyte count, aneurysm ruptured intraoperatively and Glasgow Outcome Scale scores at 3 months. Both hyponatremia and hypernatremia were not associated with 3-month outcomes. Neither hypernatremia nor hyponatremia was associated with the risk of symptomatic vasospasm. |
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