Syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting as the common causes of hyponatremia in tertiary care hospital

Background: Hyponatremia is a typical condition of electrolyte disturbance that may be euvolemic, hypovolemic or hypervolemic. Proper interpretation through laboratory tests helps to differentiate the types and causes of hyponatremia. This study was conducted to evaluate the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW) as the common causes of hyponatremia in tertiary care hospital.Methods: A prospective interventional study was conducted, including hyponatremia cases, admitted in NTU/ICU/CCU and other medical wards at Ruby Hall Clinic from August 2011 to December 2013.Results: Of 150 patients enrolled in this study, 33.33% patients were euvolemic, 34% patients were hypervolemic and 32.66% patients were hypovolemic. For the euvolemic patients, SIADH (68%) was the most common cause; whereas, CSW (34.39%) was the common cause for hypovolemic type of hyponatremia. Stroke was found to be the most common cause of SIADH (55.88%), Intra-cerebral bleeding was observed to be the most common causative factor between SIADH and CSW associated hyponatremia.Conclusions: Hyponatremia in central nervous system disorder patients frequently occurred due to SIADH and CSW. Most common cause of SIADH was stroke and for CSW it was intra cerebral bleed.

Alive with almost no Brain: Severe Post-Hemorrhagic Internal Hydrocephalus

Objectives: Severe post-hemorrhaghic internal hydrocephalus with almost complete atrophy of the cerebral parenchyma, as in the following case, is rare. Case report: A 19yo Caucasian female with a history of premature birth, perinatal intraventricular bleeding, developmental delay, mental retardation, and epilepsy, was admitted for recurrent generalized tonic-clonic seizures. She was able to produce some noises but was unable to communicate with understandable speech. There was severe mental retardation, motor deficits, and tetraspasticity. She was able to sit and eat but was otherwise dependent on the parents’ support. Monotherapy with primidon since age 15y was increased to 500mg/d. A CT scan of the cerebrum showed a massive internal hydrocephalus with atrophy of the basal ganglia, the white matter, the cerebellum, but also the cortex. Neurosurgeons decided against a shunt. Conclusions: Despite severe atrophy of the cerebral parenchyma, severe post-hemorrhagic internal hydrocephalus, manifesting as psychomotor retardation, epilepsy, and tetraspasticity, is compatible with life.

Effects of Yugong Qili Duoming Capsule on Expression of Bc1-2 in Brain Tissue of Cerebral Bleeding Model Rats / 中国中医药信息杂志

Objective To explore the curative mechanism of Yugong Qili Duoming Capsule for cerebral hemorrhage. Methods The model rats were established by being injected its blood to its own basal segmental, which induced cerebral bleeding. Bc1-2 was determined with immunohistochemical method and was used to evaluate the effect of Yugong Qili Duoming Capsule on the treatment group and other comparative group. Results The Bc1-2 cells in brain issue of model groups began to increase at the 1st day, reached its highest level at the 2nd day and decreased greatly at the 7th day. However, the Bcl-2 cells of the treatment group were much more than those of the model groups in the 2nd, 4th and 7th day. Conclusion Yugong Qili Duoming Capsule can increase expression of Bc1-2 in brain tissue of cerebral bleeding model rats.