Cerebral salt-wasting syndrome

The central salt wasting syndrome (syn. cerebral salt wasting syndrome) is a rare syndrome that occurs in severe brain damage caused by the malfunction of the " central nervous system " and must be treated in intensive care. It is connected by one, thereby caused heavy loss of sodium chloride through the kidneys and associated hyponatremia in the blood with a blood volume deficiency identified.

The syndrome was first described in 1950 by J. Peters.

Cause

Trigger can for example be a subarachnoid hemorrhage due to a stroke or a traumatic brain injury. Also in the context of glioma, tuberculosis and carcinomatous meningitis ( meningeal involvement in tumors ), the syndrome was observed.

As the underlying cause a disturbance of the function of the hypothalamus is assumed in the context of which occurs a disturbance of excretion of atrial natriuretic factor. At the same time a change in brain natriuretic peptide in blood is detectable in the clinical picture. The exact pathogenetic mechanism is not yet understood.

Therapy

In contrast to the Black - Bartter syndrome ( dilutional ) the compensation of the lost volume by means of isotonic saline is ostensibly the " central salt wasting syndrome ". In addition, the therapy with fludrocortisone can be supplemented with the aim to enhance the sodium re in the kidney. Intensive care monitoring is mandatory.