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April 1960

Hyponatremia Following Craniotomy

Author Affiliations

San Francisco
From the Division of Neurological Surgery, University of California School of Medicine, and the Fort Miley Veterans Administration Hospital, San Francisco.

AMA Arch Neurol. 1960;2(4):391-398. doi:10.1001/archneur.1960.03840100029005

The term "hyponatremia" denotes an abnormally low concentration of sodium in the blood serum. The total content of sodium in the body and the serum sodium concentration may vary independently. Wynn and Rob41 described three types of hyponatremic (hypotonic) syndromes. These were symptomless hypotonicity in patients with chronic diseases, sodium depletion without water depletion, and water intoxication or dilution hyponatremia. The last is probably the commonest type in the post-operative patient who is not "depleted" and does not have significant extrarenal losses of electrolytes.

There have been several reports of post-operative hyponatremia in patients who have had mitral valvulotomy,5,35 as well as other major surgical procedures.4,14,42 The recognition of hyponatremia is particularly important in patients who have had intracranial operations, since the symptoms and signs associated with hyponatremia may simulate those of postoperative intracranial hemorrhage. In addition, postoperative hyponatremia is usually caused by the administration or net retention

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