The Relationship Between Location Of Ruptured Intracranial Aneurysm And Hyponatremia

Background : Hyponatremia is the most common form of electrolyte disturbance in patients with aneurysmal subarachnoid hemorrhage(a SAH).Abnormal antidiuretic hormone secretion syndrome(SIADH)and cerebral salt wasting syndrome(CSWS)are the most common etiology.Objective: Clinical data of patients with aneurysm subarachnoid hemorrhage complicated with hyponatremia admitted to Shengjing Hospital of China Medical University were retrospectively analyzed to try to determine whether the incidence of SIADH and CSWS after SAH differs depending on the location of ruptured aneurysmMethod: Retrospective analysis in January 2016 to December 2018 in shengjing hospital affiliated to China medical university neurosurgery doctor aneurysm subarachnoid hemorrhage complicated with hyponatremia in patients with clinical data,such as age,gender,aneurysm,hyponatremia causes,operation way,the hospital Hunt-Hess classification,WFNS stage,improved Fisher,grading,modified Rankin scale scores and other indicators when discharged from hospital,according to the causes of hyponatremia,divided into SIADH group(N = 120)and CSWS group(N = 40),compare the clinical features of two groups.Univariate analysis and multivariate Logistic regression were used to analyze the factors influencing the etiology of hyponatremia.Result: A total of 200 patients developed hyponatremia,120(60%)due to SIADH,40(20%)due to CSWS,and 40(20%)due to other causes.Patients with SIADH and CSWS were included in the study,including 102(64%)patients with anterior circulation aneurysms and 58(36%)patients with posterior circulation aneurysms.Univariate analysis confirmed that SIADH was more common in anterior circulation aneurysms than CSWS(P=0.004)compared with posterior circulation aneurysms.Compared with other sites,the incidence of SIADH was higher in anterior communicating aneurysms than in CSWS(P=0.038).More severe Hunt-Hess grading was associated with the development of CSWS(P=0.007);Patients in the CSWS group were more likely to develop early hyponatremia than those in the SIADH group(P=0.03).Multivariate Logistic regression analysis further confirmed that the incidence of SIADH in patients with anterior circulation aneurysm was significantly higher than that in patients with posterior circulation aneurysm(P=0.041).The incidence of CSWS was higher in patients with Hunt-Hess grade 3-4(P=0.013).Conclusion: SIADH is more common in anterior circulating aneurysms than aneurysms compared to recirculating aneurysms;the incidence of CSWS is higher in patients with Hunt-Hess grade 3-4 than in patients with recirculating aneurysms;early hyponatremia is more common in CSWS in CSWS group than in patients with recirculating aneurysms;and hyponatremia lasts less than in patients with SIADH groups...