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Cerebral salt-wasting syndrome (CSWS), also written cerebral salt wasting syndrome, is a rare endocrine condition featuring a low blood sodium concentration and dehydration in response to injury (trauma) or the presence of tumors in or surrounding the brain. In this condition, the kidney is functioning normally but excreting excessive sodium. [1]
Cerebral salt wasting syndrome (CSWS) also presents with hyponatremia, there are signs of dehydration for which reason the management is diametrically opposed to SIADH. Importantly CSWS can be associated with subarachnoid hemorrhage (SAH) which may require fluid supplementation rather than restriction to prevent brain damage.
Signs and symptoms of psychogenic polydipsia include: [3] Excessive thirst and xerostomia, leading to overconsumption of water; Hyponatraemia, causing headache, muscular weakness, twitching, confusion, vomiting, irritability etc., although this is only seen in 20–30% of cases.
The treatment of hyponatremia depends on the underlying cause. [12] How quickly treatment is required depends on a person's symptoms. [12] Fluids are typically the cornerstone of initial management. [12] In those with severe disease an increase in sodium of about 5 mmol/L over one to four hours is recommended. [12]
Severity of symptoms is directly correlated with severity of hyponatremia and rapidness of onset. [3] General symptoms include loss of appetite, nausea, vomiting, confusion, agitation, and weakness. [14] [3] More concerning symptoms involve the central nervous system and include seizures, coma, and death due to brain herniation.
The symptoms of CAH vary depending upon the form of CAH and the sex of the patient. Symptoms can include: Due to inadequate mineralocorticoids: [citation needed] Vomiting due to salt-wasting, leading to dehydration and death; Due to excess androgens: In extreme virilization, clitoromegaly (elongated clitoris) with a phallic-like structure is seen.
Early symptoms of hypovolemia include headache, fatigue, weakness, thirst, and dizziness. The more severe signs and symptoms are often associated with hypovolemic shock. These include oliguria , cyanosis , abdominal and chest pain, hypotension , tachycardia , cold hands and feet, and progressively altering mental status.
Reversible cerebral vasoconstriction syndrome (RCVS, sometimes called Call-Fleming syndrome) is a disease characterized by a weeks-long course of thunderclap headaches, sometimes focal neurologic signs, and occasionally seizures. [1] Symptoms are thought to arise from transient abnormalities in the blood vessels of the brain. [1]