Intensive Care Medicine

, Volume 34, Issue 1, pp 125–131 | Cite as

Hyponatremia in neurological patients: cerebral salt wasting versus inappropriate antidiuretic hormone secretion

  • Serge BrimioulleEmail author
  • Carlos Orellana-Jimenez
  • Adel Aminian
  • Jean-Louis Vincent



To assess whether hyponatremia in acute neurological patients is associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or with the cerebral salt-wasting syndrome (CSWS).


Clinical, controlled, prospective study.


Department of intensive care of a tertiary care academic hospital.


Forty acute neurological patients with hyponatremia suggesting SIADH or CSWS (20) or with normonatremia (20).



Measurements and main results

Measurement of clinical and biological variables. Measurement of blood, plasma, and red blood cell volumes to discriminate SIADH and CSWS. Renal, adrenal and thyroid functions were normal in all patients. Average blood, plasma, and red blood cell volumes were 54, 37 and 17 ml/kg in control patients and 54, 37 and 18 ml/kg in hyponatremic patients, respectively.


The adequate blood volumes in hyponatremic patients confirm the diagnosis of SIADH and do not support the concept of CSWS.


Antidiuretic hormone Natriuretic factor Natriuretic peptide Subarachnoid hemorrhage Brain trauma Intracranial disease 

Supplementary material

134_2007_905_MOESM1_ESM.doc (30 kb)
Electronic Supplementary Material (DOC 179K)


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Serge Brimioulle
    • 1
    Email author
  • Carlos Orellana-Jimenez
    • 1
  • Adel Aminian
    • 1
  • Jean-Louis Vincent
    • 1
  1. 1.Department of Intensive CareErasme University Hospital, Free University of BrusselsBrusselsBelgium

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