Cerebral Salt Wasting Syndrome-A Central Nervous Disorders: Diagnosis, Management, And Treatment

Abstract

Background: Cerebral Salt Wasting Syndrome (CSW) is a condition often associated with central nervous system (CNS) disorders, characterized by hyponatremia, hypovolemia, and elevated urinary sodium excretion. Its differentiation from Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is critical due to opposing management strategies.

Aim: This article aims to explore the diagnosis, management, and treatment of CSW, emphasizing its pathophysiology, clinical features, and therapeutic approaches.

Methods: A review of current literature and case studies was conducted, focusing on CSW's epidemiology, pathophysiology, diagnostic criteria, and treatment protocols.

Results: CSW is most commonly observed in cases of aneurysmal subarachnoid hemorrhage, with other triggers including CNS surgeries, infections, and malignancies. Pathophysiological mechanisms involve hypothalamic dysfunction and the release of brain natriuretic peptide, leading to excessive natriuresis and hypovolemia. Diagnostic criteria include distinguishing features of hypovolemia and laboratory findings such as low serum sodium and high urinary sodium levels. Management entails fluid and sodium supplementation, with isotonic or hypertonic saline being common treatments.

Conclusion: CSW remains a diagnostic and therapeutic challenge due to its overlap with SIADH. Early recognition and accurate differentiation are essential for effective management, preventing complications such as neurological damage or exacerbated electrolyte imbalances. Further research into its pathophysiology may provide insights for targeted interventions.