deamino-arginine-vasopressin and Subarachnoid-Hemorrhage

To discuss the management of patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) developing after subarachnoid hemorrhage, in a comparative manner in the light of the literature.. Without country or language restrictions, articles with high evidential value found in electronic databases were compared to our patients?. After the literature review, three articles were included for systematic evaluation. Desmopressin was administered to the patients for the treatment of hyponatremia, volume contraction, and negative sodium balance caused by SIADH. However, it was not used for preventing re-bleeding.. To prevent the development of this complication (SIADH), the use of desmopressin, an analogue of vasopressin, is important in routine clinical practice.

Topics: Deamino Arginine Vasopressin; Humans; Inappropriate ADH Syndrome; Male; Middle Aged; Subarachnoid Hemorrhage

Hypodipsic hypernatremia (HH) represents a pathological increase in serum sodium due to a lack of thirst and defect in hypothalamic osmoreceptors. While 15% of patients with HH have a vascular aetiology, few cases have been described. Moreover, the presence of such abnormalities in the amnestic patient can have particularly threatening implications, as HH tends to recur unless the patient complies with a regimen of water intake. This study reports the case of a 46-year-old male admitted for rehabilitation of functional deficits following subarachnoid haemorrhage (SAH), with clipping of an anterior communicating artery (ACoA) aneurysm. Clinical examination was remarkable for profound short-term memory loss and inability to retain new information. Blood chemistry on admission showed a serum sodium level of 160 mEq/L, increasing to 167 mEq/L the following day. The patient denied thirst, and showed no clinical signs of dehydration. Neuroendocrine evaluation revealed diabetes insipidus (DI) and HH. Treatment initially included DDAVP and intravenous hydration, later supplemented with chlorpropramide. Stabilization of serum sodium and osmolality did not ensue until the treatment regimen included hydrochlorothiazide and supervision of enforced fluid intake. Endocrine abnormalities may be encountered among patients with vascular lesions adjacent to the hypothalamus. Rehabilitation interventions include establishing a structured medication regimen with fluid administration in the amnestic patient with hypothalamic dysfunction.

Topics: Amnesia, Anterograde; Chlorpropamide; Deamino Arginine Vasopressin; Diabetes Insipidus; Diuretics; Drinking Behavior; Drug Administration Schedule; Fluid Therapy; Humans; Hydrochlorothiazide; Hypernatremia; Hypoglycemic Agents; Intracranial Aneurysm; Male; Middle Aged; Postoperative Complications; Renal Agents; Subarachnoid Hemorrhage; Thirst

Topics: Adolescent; Cerebral Hemorrhage; Cerebral Ventricles; Combined Modality Therapy; Deamino Arginine Vasopressin; Female; Humans; Intracranial Arteriovenous Malformations; Subarachnoid Hemorrhage; von Willebrand Diseases

We describe a patient who developed a delayed postoperative hematoma while receiving hypertensive therapy for delayed cerebral ischemia after aneurysm operation. The association between delayed extradural hematoma and induced hypertension has not been described previously.

Topics: Adult; Blood Pressure; Blood Transfusion; Brain Ischemia; Cerebrovascular Circulation; Combined Modality Therapy; Deamino Arginine Vasopressin; Dopamine; Female; Fluid Therapy; Hematoma, Epidural, Cranial; Humans; Intracranial Aneurysm; Subarachnoid Hemorrhage