Сlinical cases of symptomatic hyponatremia

U.A. Fesenko, O.S. Stepanyuk, T.B. Zhovnir


The case series of four symptomatic hyponatremia in patients with cerebral diseases are analyzed. In all cases hyponatremia was severe (serum sodium level < 125 mmol/L) with the signs of cerebral edema, and poorly corrected. For the correction of hyponatremia, we used the intravenous infusion of 7.5% NaCl, and the average rate of correction was 9 mmol/L per day. The clinical signs of hyponatremia mimic as ischemic stroke and epilepsy. The moderate level of hyponatremia (125–129 mmol/L) did not correspond to the symptoms of cerebral edema. The most possible causes of hyponatremia were: traumatic brain injury, administration of X-ray contrast and furosemide, and infusion of 5% dextrose. Except the main suspected causing factor, all patients had several other factors that could predispose the development of hyponatremia. All patients presented with hypochloremia.


hyponatremia; cerebral pathology; hypochloremia


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