Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1988 Apr;51(4):516–520. doi: 10.1136/jnnp.51.4.516

Enlargement of the third ventricle and hyponatraemia in aneurysmal subarachnoid haemorrhage.

E F Wijdicks 1, K J Vandongen 1, J Vangijn 1, A Hijdra 1, M Vermeulen 1
PMCID: PMC1032961  PMID: 3379424

Abstract

Hyponatraemia following aneurysmal subarachnoid haemorrhage is associated with an increased risk of cerebral infarction. Whether the development of hyponatraemia was related to enlargement of the third ventricle on the admission CT scan was investigated in a consecutive series of 133 patients who were seen within 72 hours of aneurysmal haemorrhage. Hyponatraemia occurred significantly more often in patients with enlargement of the third ventricle (with or without dilatation of the lateral ventricles) than in patients with a normal ventricular system (20/41 versus 24/92, p = 0.016). After ventricular drainage, the sodium levels returned to normal in two patients in whom the size of the third ventricle decreased and not in four patients with persistent enlargement of the third ventricle. The significant relationship between enlargement of the third ventricle and hyponatraemia remained after adjustment for the amount of cisternal blood, but not after adjustment for the amount of intraventricular blood. These results suggest that the size of the third ventricle is an important but not the only factor in the relationship between acute hydrocephalus and hyponatraemia in patients with aneurysmal subarachnoid haemorrhage.

Full text

PDF
516

Images in this article

517Image
on p.517
518Image
on p.518

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CROMPTON M. R. Hypothalamic lesions following the rupture of cerebral berry aneurysms. Brain. 1963 Jun;86:301–314. doi: 10.1093/brain/86.2.301. [DOI] [PubMed] [Google Scholar]
  2. Doshi R., Neil-Dwyer G. A clinicopathological study of patients following a subarachnoid hemorrhage. J Neurosurg. 1980 Mar;52(3):295–301. doi: 10.3171/jns.1980.52.3.0295. [DOI] [PubMed] [Google Scholar]
  3. Dóczi T., Bende J., Huszka E., Kiss J. Syndrome of inappropriate secretion of antidiuretic hormone after subarachnoid hemorrhage. Neurosurgery. 1981 Oct;9(4):394–397. doi: 10.1227/00006123-198110000-00008. [DOI] [PubMed] [Google Scholar]
  4. Kassell N. F., Peerless S. J., Durward Q. J., Beck D. W., Drake C. G., Adams H. P. Treatment of ischemic deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. Neurosurgery. 1982 Sep;11(3):337–343. doi: 10.1227/00006123-198209000-00001. [DOI] [PubMed] [Google Scholar]
  5. Kistler J. P., Crowell R. M., Davis K. R., Heros R., Ojemann R. G., Zervas T., Fisher C. M. The relation of cerebral vasospasm to the extent and location of subarachnoid blood visualized by CT scan: a prospective study. Neurology. 1983 Apr;33(4):424–436. doi: 10.1212/wnl.33.4.424. [DOI] [PubMed] [Google Scholar]
  6. Meese W., Kluge W., Grumme T., Hopfenmüller W. CT evaluation of the CSF spaces of healthy persons. Neuroradiology. 1980 Apr;19(3):131–136. doi: 10.1007/BF00342387. [DOI] [PubMed] [Google Scholar]
  7. Palluk R., Gaida W., Hoefke W. Atrial natriuretic factor. Life Sci. 1985 Apr 15;36(15):1415–1425. doi: 10.1016/0024-3205(85)90048-7. [DOI] [PubMed] [Google Scholar]
  8. Pasqualin A., Rosta L., Da Pian R., Cavazzani P., Scienza R. Role of computed tomography in the management of vasospasm after subarachnoid hemorrhage. Neurosurgery. 1984 Sep;15(3):344–353. doi: 10.1227/00006123-198409000-00009. [DOI] [PubMed] [Google Scholar]
  9. Takaku A., Shindo K., Tanaka S., Mori T., Suzuki J. Fluid and electrolyte disturbances in patients with intracranial aneurysms. Surg Neurol. 1979 May;11(5):349–356. [PubMed] [Google Scholar]
  10. Vermeulen M., Lindsay K. W., Murray G. D., Cheah F., Hijdra A., Muizelaar J. P., Schannong M., Teasdale G. M., van Crevel H., van Gijn J. Antifibrinolytic treatment in subarachnoid hemorrhage. N Engl J Med. 1984 Aug 16;311(7):432–437. doi: 10.1056/NEJM198408163110703. [DOI] [PubMed] [Google Scholar]
  11. Wijdicks E. F., Vermeulen M., Hijdra A., van Gijn J. Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: is fluid restriction harmful? Ann Neurol. 1985 Feb;17(2):137–140. doi: 10.1002/ana.410170206. [DOI] [PubMed] [Google Scholar]
  12. Wijdicks E. F., Vermeulen M., ten Haaf J. A., Hijdra A., Bakker W. H., van Gijn J. Volume depletion and natriuresis in patients with a ruptured intracranial aneurysm. Ann Neurol. 1985 Aug;18(2):211–216. doi: 10.1002/ana.410180208. [DOI] [PubMed] [Google Scholar]
  13. Wijdicks E. F., Vermeulen M., van Brummelen P., den Boer N. C., van Gijn J. Digoxin-like immunoreactive substance in patients with aneurysmal subarachnoid haemorrhage. Br Med J (Clin Res Ed) 1987 Mar 21;294(6574):729–732. doi: 10.1136/bmj.294.6574.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wise B. L. Inappropriate secretion of ADH caused by obstruction of ventriculoatrial shunts. J Neurosurg. 1968 May;28(5):429–433. doi: 10.3171/jns.1968.28.5.0429. [DOI] [PubMed] [Google Scholar]
  15. van Gijn J., Hijdra A., Wijdicks E. F., Vermeulen M., van Crevel H. Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1985 Sep;63(3):355–362. doi: 10.3171/jns.1985.63.3.0355. [DOI] [PubMed] [Google Scholar]
  16. van Gijn J., van Dongen K. J. Computerized tomography in subarachnoid hemorrhage: difference between patients with and without an aneurysm on angiography. Neurology. 1980 May;30(5):538–539. doi: 10.1212/wnl.30.5.538. [DOI] [PubMed] [Google Scholar]
  17. van Gijn J., van Dongen K. J., Vermeulen M., Hijdra A. Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology. 1985 Apr;35(4):493–497. doi: 10.1212/wnl.35.4.493. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES