Comment prendre en charge une dysnatrémie en neuroréanimation ?

Dysnatremia are common metabolic disorders in critically ill neurological patients. Changes in plasma osmolality, associated with changes in sodium concentration may induce intracranial hypertension and cerebral haemorrhage. The syndromes of inappropriate antidiuretic hormone secretion and cerebral salt wasting are the two main causes of hyponatremia. Thyroid and adrenal glands functions need to be evaluated in patients with hyponatremia. Hypernatremia occurs in 15% of critically ill neurological patients. The main cause of hypernatremia is insipidus diabetes related to a lack of antidiuretic hormone secretion. Disorders of sodium plasma concentration need to be rapidly corrected in critically ill neurological patients.