Akute symptomatische Hyponatriämie bei einem 70-jährigen Patienten

Abstract

This etiologic correlation was reported in literature by many authors. However, these SIADHs were associated with a big subdural hematoma which needed neurosurgical intervention in most of the cases. Our patient is unique in that his symptoms were caused by a small subdural hematoma, which did not need surgical intervention. The patient was treated with cautious saline infusion, administration of a loop diuretic and fluid restriction with improvement of both his clinical and metabolic state. As large water loads may result in severe hyponatremia in these patients, moderate fluid restriction appears to be effective in long-term management even after stabilization/normalization of serum sodium. There are no sufficient data about the incidence of asymptomatic hyponatremia due to SIADH resulting from minor head injury, because most of these patients are asymptomatic and therefore they do not receive clinical attention.