Inappropriate antidiuresis syndrome secondary to parasellar aneurysm subarachnoid hemorrhage

Abstract

The presence of an electrolyte imbalance, primarily hyponatremia, is often a prevalent complication during patient hospitalization, caused by various factors. Case Presentation. A 65-year-old male patient consulted for a thunderclap headache and transient altered alertness. Laboratory tests documented the presence of euvolemic hypoosmolar hyponatremia and hypokalemia. His CT scan showed a Fisher 3 subarachnoid hemorrhage, and MRI revealed a parasellar aneurysm displacing the left lobe of the pituitary gland. Treatment. During his hospital stay, he continued to have hyponatremia and was started on hypertonic solutions, without resolution. Given the persistence of hyponatremia despite hypertonic solutions, a high suspicion of syndrome of inappropriate antidiuretic hormone secretion (SIAD) was raised, fluid restriction was initiated with less than 1000 ml/day of daily intake. Clinical evolution. After four days, the patient's hyponatremia resolved, and the neurosurgery subspecialty managed the aneurysm.