cerebral salt wasting syndrome
A condition characterized by hyponatremia and volume depletion following acute brain injury, distinct from SIADH.
Full Definition
Cerebral salt wasting syndrome (CSWS) is a disorder of sodium and water homeostasis that occurs following acute central nervous system injury, most commonly subarachnoid hemorrhage, traumatic brain injury, or neurosurgical procedures. CSWS is characterized by hyponatremia, elevated urine sodium excretion, and volume depletion (euvolemia or hypovolemia). The pathophysiology involves increased natriuretic peptide release leading to excessive renal sodium losses. Distinguishing CSWS from syndrome of inappropriate antidiuretic hormone secretion (SIADH) is crucial because treatment approaches differ significantly: CSWS requires sodium and volume replacement, while SIADH requires fluid restriction. Clinical assessment of volume status, measurement of natriuretic peptides, and careful monitoring of fluid balance are essential for accurate diagnosis and appropriate management.
Usage
Usage note: Often confused with SIADH due to similar presentation of hyponatremia. Volume status assessment is key to differentiation.
In Context
- "The patient developed cerebral salt wasting syndrome requiring aggressive sodium replacement therapy." — Neurocritical care consultation
- "Distinguishing CSWS from SIADH proved challenging given the overlapping clinical presentations." — Clinical case discussion