Clinical semiology and neuroradiologic correlates of acute hypernatremic osmotic challenge in adults: a literature review

The complex interplay between hypernatremic osmotic disturbances and cerebral lesions is yet to be clarified. In this review, we discuss, on the basis of the reported data of hypernatremic CNS challenge in the adult population, the clinical and radiologic features of the condition. Our search captur...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2013-12, Vol.34 (12), p.2225-2232
Main Authors: Ismail, F Y, Szóllics, A, Szólics, M, Nagelkerke, N, Ljubisavljevic, M
Format: Article
Language:English
Subjects:
Adult
Brain Diseases - diagnosis
Brain Diseases - etiology
Demyelinating Diseases - diagnosis
Demyelinating Diseases - etiology
Female
Humans
Hypernatremia - complications
Hypernatremia - diagnosis
Male
Neuroradiography
Review
Statistics as Topic
Symptom Assessment - statistics & numerical data
Syndrome
Young Adult
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Summary:The complex interplay between hypernatremic osmotic disturbances and cerebral lesions is yet to be clarified. In this review, we discuss, on the basis of the reported data of hypernatremic CNS challenge in the adult population, the clinical and radiologic features of the condition. Our search captured 20 case studies and 1 case series with 30 patients in total who acquired acute hypernatremia due to different etiologies and developed CNS lesions. We explored the associations between premorbid conditions, clinical presentation, hypernatremic state, correction rate, and radiologic appearance, including the localization of brain lesions and the outcomes. The results revealed that altered mental status was the most commonly reported symptom and osmotic demyelination syndrome in the form of extrapontine myelinolysis was the prevailing radiologic pattern. Finally, we contrasted, when appropriate, clinical and experimental data related to hypernatremic and hyponatremic osmotic insults to aid the understanding of the pathophysiology of CNS osmotic brain injury.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A3392