Abstract

Background - Hyponatremia has numerous causes, but in neurologically ill patients, Syndrome of Inappropriate Antidiuresis (SIADH) and Cerebral Salt Wasting (CSW) are the most common. Both these entities are cerebral In origin but have distinct pathophysiology, prognosis and treatment options. Thus most CSW patients meet the criteria for SIADH and have elevated AVP levels but worsen with the treatment protocol given for SIADH. Hence, we conducted this prospective study to describe the aetiology of hyponatremia in patients of stroke. Materials and Methods- This was a prospective observational study was included all inpatients of stroke either ischemic or haemorrhagic admitted in the Department of General Medicine at a tertiary care hospital. A total of 50 patients were included in the study over a duration of 22 months between 22 Nov 2020 to Aug 2022. Patients willing to participate in the study, age more than 18years with established cases of stroke (ischemic or haemorrhagic) on the basis of clinical history, examination and brain imaging were included in the present study. Results- Among SIADH patients, 83.3% had ischemic stroke and 16.7% had hemorrhagic stroke. Among cerebral salt wasting patients, ischemic stroke was found in 100% of patients. The difference in stroke type seen in the various conditions did not reach statistical significance(p>0.05). Conclusion Hyponatremia in the setting of stroke occurs in 14% of patients. The prevalence is higher in males and among the middle aged. Hyponatremia was more common in ischemic stroke than hemorrhagic stroke.

Description