Inappropriate Secretion of Antidiuretic Hormone: A Rare Complication after Carotid Endarterectomy

Abstract

The syndrome of inadequate secretion of the antidiuretic hormone (SIADH) is a very rare complication after carotid endarterectomy, characterized by hyponatremia, decrease of serum osmolarity as well as an increase in urinary osmolarity. We report the case of an 80-year-old woman who developed, 24 hours after the surgery, a picture of drowsiness and lethargy without neurological focality. The diagnosis of SIADH was suspected. We conclude that is important to have in mind this clinical entity in the differential diagnosis of non-focal neurological deficit after carotid endarterectomy.

A rare case of neurological dysfunction due to severe hyponatremia after carotid artery endarterectomy: A review of the clinical approach to hyponatremia

“…Previously, only three cases of significant hyponatremia following CEA have been reported. [2][3][4] Of these, only one report described severe hyponatremia with a sodium of 119 mmol/L. Unlike previous cases, our patient developed profound hyponatremia with a sodium level of 109 mmol/L.…”

“…This case highlights the need for heightened vigilance for the possibility of hyponatremia as the cause of neurological dysfunction after CEA. Previously, only three cases of significant hyponatremia following CEA have been reported 2–4 . Of these, only one report described severe hyponatremia with a sodium of 119 mmol/L.…”