Risk factors and treatment of secondary hyponatremia in patients with ruptured intracranial aneurysms after surgical clipping
DAI Kun
ZHU Yun
SUN Xiao-ou
YOU Wan-chun
MA Chao
WANG Wei
JI Cheng-yuan
WANG Zhong
Abstract：Objective To investigate the risk factors and treatment of secondary hyponatremia after surgical clipping of ruptured intracranial aneurysms.Methods The clinical data of 102 patients with ruptured intracranial aneurysms treated with surgical clipping from January 2018 to January 2022 were retrospectively analyzed.Hyponatremia was diagnosed when serum sodium fell below 135 mmol/L twice within 1 week after surgery.The risk factors of hyponatremia were analyzed by multivariate logistic regression model.Targeted treatment was performed according to the cause of hyponatremia[syndrome of inappropriate secretion of antidiuritic homone(SIADH)and cerebral salt wasting(CSWS)].Results Of these 102 patients,40 patients(39.2％)had hyponatremia after operation,including 19 mild,15 moderate,and 6 severe hyponatremia;23 SIADH and 17 CSWS.Multivariate logistic regression analysis showed that the location of aneurysms in the anterior cerebral artery and anterior communicating artery(OR=2.564;95％CI 1.035-6.349;P=0.042),preoperative Hunt-Hess grade Ⅲ～Ⅳ(OR=3.223;95％CI 1.306-7.953;P=0.011),and combined hydrocephalus(OR=3.135;95％CI 1.097-8.963;P=0.033)were independent risk factors for secondary hyponatremia.The blood sodium level returned to normal in all patients before discharge.During the follow-up(3-6 months),6 patients had headache and nausea due to hyponatremia,and they recovered after oral or intravenous sodium supplementation.Conclusions Hyponatremia is easily occurred after surgical clipping of intracranial ruptured aneurysms,especially in patients with aneurysms located in the anterior communicating artery or anterior cerebral artery,high Hunt-Hess grade,and combined with hydrocephalus.More attention should be paid to the observation and monitoring of electrolyte levels,and timely correction,so as to improve the prognosis of patients.
Keywords：Ruptured intracranial aneurysmsSubarachnoid hemorrhageHyponatremiaSurgical clippingRisk factors
Publication Date：2023-09-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 566-568,572 )