• Critical care clinics · Jan 2001

    Review

    Cerebral salt wasting syndrome.

    • M R Harrigan.
    • Department of Surgery, Section of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA. harrigan@umich.edu
    • Crit Care Clin. 2001 Jan 1; 17 (1): 125-38.

    AbstractThere is significant evidence to show that many patients with hyponatremia and intracranial disease who were previously diagnosed with SIADH actually have CSW. The critical difference between SIADH and CSW is that CSW involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. Attention to volume status in patients with hyponatremia is essential. The primary treatment for CSW is water and salt replacement. The mechanisms underlying CSW are not understood but may involve ANP or other natriuretic factors and direct neural influence on renal function. Future investigation is needed to better define the incidence of CSW in patients with intracranial disease, identify other disorders that can lead to CSW, and elucidate the mechanisms underlying this syndrome.

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