Hiponatremia w przebiegu obrażeń mózgu.

Hyponatraemia can complicate the clinical outcome in traumatic brain injury. As a result of brain injuries, two disease syndromes may arise: SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion) and CSWS (Cerebral Salt-Wasting Syndrome). In SIADH the cause of hyponatraemia is excessive water reabsorption causing dilution of Na+ ions. CSWS is a syndrome of hypovolemic hyponatraemia caused by renal natriuresis and diuresis. Brain natriuretic peptide, secreted by the injured brain plays a crucial role in the pathogenesis of CSWS. Making a distinction between SIADH and CSWS is important due to different treatment required for the two conditions. In the differentiation of SIADH and CSWS the index fractional uric acid secretion plays the greatest role. In both of these disease states it is elevated, but only in SIADH it normalizes after correction of hyponatremia. The maintenance of normal levels of serum sodium in patient with TBI may help alleviate increases in ICP as well as can avoid intensifying neurological deficit in these two syndromes. [ABSTRACT FROM AUTHOR]