engleski

Cerebral vasospasm and hyponatremia following aneurysmal subarachnoid hemorrhage : Possible role of endogenous digoxin-like substance

The aim of the study was to test the hypothesis that the concentrations of endogenous digoxin-like immunoreactive substance (DLIS) are increased in the initial period after the onset of spontaneous subarachnoid aneusysmal hemorrhage (SSAH) and may contribute to the genesis of arterial vasospasm and lowered serum sodium levels. Fifty-three consecutive nonoperated patients of both sexes were included in the study. Time-course of the changes in plasma concentrations of DLIS (AxSYM Digoxin II fluoroimmunoassay) and changes in serum sodium concentration in patients during days 1-14 after the onset of SSAH were followed. The presence of DLIS was noted in serum of more than 80% of patients on day 1 after the onset of SSAH. The mean values of DLIS increased significantly between day 1 and 7, and then decreased below the initial values on day 14. Serum sodium levels were significantly lowered on day 7 after the onset of SSAH. In the subgroup of patients with multiple vasospasms, the levels of DLIS were significantly higher compared with the levels of DLIS in the subgroup of patients free from vasospasms. Serum sodium levels were significantly lowered in patients showing vasospasm compared with sodium levels in patients without vasospasms. Authors' results suggest the possible role of serum DLIS as a mediator in the development of arterial vasospasms and sodium metabolism disturbance.

hyponatremia; aneurismal

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