Advertisement
Original Research| Volume 103, P131-140, September 2022

Download started.

Ok

The impact of hormonal dynamics and serum sodium fluctuations on symptomatic vasospasm after subarachnoid hemorrhage

  • Tomoaki Harada
    Affiliations
    Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan
    Search for articles by this author
  • Yoichi Uozumi
    Correspondence
    Corresponding author at: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
    Affiliations
    Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan
    Search for articles by this author
  • Hidenori Fukuoka
    Affiliations
    Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-2 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan
    Search for articles by this author
  • Shigeru Miyake
    Affiliations
    Department of Neurosurgery, Kita-Harima Medical Center, 926-250 Ichiba cho, Ono 675-1392, Japan
    Search for articles by this author
  • Daisuke Yamamoto
    Affiliations
    Department of Neurosurgery, Kita-Harima Medical Center, 926-250 Ichiba cho, Ono 675-1392, Japan
    Search for articles by this author
  • Yusuke Okamura
    Affiliations
    Department of Neurosurgery, Toyooka Hospital, 1094 Tomaki, Toyooka 668-8501, Japan
    Search for articles by this author
  • Taiji Ishii
    Affiliations
    Department of Neurosurgery, Toyooka Hospital, 1094 Tomaki, Toyooka 668-8501, Japan
    Search for articles by this author
  • Shotaro Tatsumi
    Affiliations
    Department of Neurosurgery, Steel Memorial Hirohata Hospital, 3-1 Yumesaki cho, Hirohata ku, Himeji 671-1122, Japan
    Search for articles by this author
  • Takashi Mizobe
    Affiliations
    Department of Neurosurgery, Hyogo Brain and Heart Center, 520 Saisho, Himeji 670-981, Japan
    Search for articles by this author
  • Hideo Aihara
    Affiliations
    Department of Neurosurgery, Hyogo Brain and Heart Center, 520 Saisho, Himeji 670-981, Japan
    Search for articles by this author
  • Kazuhiro Tanaka
    Affiliations
    Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan
    Search for articles by this author
  • Eiji Kohmura
    Affiliations
    Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan

    Department of Neurosurgery, Kinki Central Hospital, 3-1 Kurumazuka Itami, 664-8533, Japan
    Search for articles by this author
  • Takashi Sasayama
    Affiliations
    Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki cho, Chuo ku, Kobe 650-0017, Japan
    Search for articles by this author
  • Kobe University SAH study collaborators
    Author Footnotes
    1 The Kobe university SAH study collaborators; Drs. Atsushi Arai, Haruka Enami, Yosuke Fujimoto, Atsushi Fujita, Kenji Fujita, Yuichi Fujita, Daigo Fujiwara, Mitsuru Hashiguchi, Hideya Hayashi, Masashi Higashino, Yusuke Ikeuchi, Taichiro Imahori, Jun Imura, Hirofumi Iwahashi, Hiroto Kajimoto, Tsuyoshi Katsube, Kohei Kawamura, Hidehito Kimura, Masaaki Kohta, Masahiro Maeyama, Yasunori Matsuki, Kazuya Matsuo, Shinichi Miura, Tatsuya Mori, Yasuhiko Motooka, Masahiro Nakahara, Tomoaki Nakai, Satoshi Nakamizo, Naoto Nakamura, Kana Onobuchi, Masayuki Okada, Junichi Sakata, Tomoya Shimasaki, Hiroyasu Shose, Masahiro Sugihara, Nao Tachizawa, Hirotomo Tanaka, Jun Tanaka, Masaaki Taniguchi, Yoji Yamaguchi, Akira Yamakawa, Yusuke Yamamoto, Shunsuke Yamanishi, and Shunsuke Yamashita.
  • Author Footnotes
    1 The Kobe university SAH study collaborators; Drs. Atsushi Arai, Haruka Enami, Yosuke Fujimoto, Atsushi Fujita, Kenji Fujita, Yuichi Fujita, Daigo Fujiwara, Mitsuru Hashiguchi, Hideya Hayashi, Masashi Higashino, Yusuke Ikeuchi, Taichiro Imahori, Jun Imura, Hirofumi Iwahashi, Hiroto Kajimoto, Tsuyoshi Katsube, Kohei Kawamura, Hidehito Kimura, Masaaki Kohta, Masahiro Maeyama, Yasunori Matsuki, Kazuya Matsuo, Shinichi Miura, Tatsuya Mori, Yasuhiko Motooka, Masahiro Nakahara, Tomoaki Nakai, Satoshi Nakamizo, Naoto Nakamura, Kana Onobuchi, Masayuki Okada, Junichi Sakata, Tomoya Shimasaki, Hiroyasu Shose, Masahiro Sugihara, Nao Tachizawa, Hirotomo Tanaka, Jun Tanaka, Masaaki Taniguchi, Yoji Yamaguchi, Akira Yamakawa, Yusuke Yamamoto, Shunsuke Yamanishi, and Shunsuke Yamashita.
DOI:https://doi.org/10.1016/j.jocn.2022.07.016
The impact of hormonal dynamics and serum sodium fluctuations on symptomatic vasospasm after subarachnoid hemorrhage
Previous ArticleAssociation of pre-admission antihypertensive agents and outcomes in aneurysmal subarachnoid hemorrhage
Next ArticleRadiographic evaluation of lumbar intervertebral disc height index: An intra and inter-rater agreement and reliability study

      Highlights

      • •
        We assessed the measurement of sodium metabolism-related hormones to predict SVS.
      • •
        AVP, ACTH, and cortisol were elevated on day 1 after SAH in patients with SVS.
      • •
        Serum sodium fluctuations were associated with SVS occurrence.
      • •
        Serum sodium fluctuations were associated with stress-related hormonal dynamics.

      Abstract

      Background

      Symptomatic vasospasm (SVS) is a major cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage (SAH), and serum sodium frequently decreases before SVS. Serum sodium changes might be regulated by sodium metabolism-related hormones. This multi-institutional prospective cohort study therefore investigated the measurement of sodium metabolism-related hormones to elucidate the pathophysiology of serum sodium changes in SAH.

      Methods

      SAH patients were treated with clipping or coiling from September 2017 to August 2020 at five hospitals. The laboratory data of 133 SAH patients were collected over 14 days and correlations between changes in serum sodium, sodium metabolism-related hormones (plasma adrenocorticotropic hormone (ACTH), serum cortisol, plasma arginine vasopressin (AVP)), and SVS were determined. Serum sodium concentrations were measured every day and serum sodium levels >135 mEq/L were maintained until day 14.

      Results

      Of the 133 patients, 18 developed SVS within 14 days of subarachnoid hemorrhage onset (SVS group) and 115 did not suffer from SVS (non-SVS group). Circulating AVP, ACTH, and cortisol concentrations were significantly higher on day 1 in the SVS group compared with the non-SVS group. Fluctuations in serum sodium in the SVS group were significantly higher than those in the non-SVS group. There were antiparallel fluctuations in serum sodium and potassium from days 2 to 14.

      Conclusions

      Elevated levels of ACTH/cortisol and AVP on day 1 may be predictive markers for the occurrence of SVS. Multiple logistic regression analysis showed that serum sodium fluctuations were associated with SVS occurrence. Serum sodium fluctuations were associated with stress-related hormonal dynamics. (249 words)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • 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; 17: 137-140https://doi.org/10.1002/ana.410170206
        View in Article
        • Ferguson S.
        • Macdonald R.L.
        Predictors of cerebral infarction in patients with aneurysmal subarachnoid hemorrhage.
        Neurosurgery. 2007; 60: 658-667https://doi.org/10.1227/01.NEU.0000255396.23280.31
        View in Article
        • Rabinstein A.A.
        • Friedman J.A.
        • Weigand S.D.
        • McClelland R.L.
        • Fulgham J.R.
        • Manno E.M.
        • et al.
        Predictors of cerebral infarction in aneurysmal subarachnoid hemorrhage.
        Stroke. 2004; 35: 1862-1866
        View in Article
        • Uozumi Y.
        • Mizobe T.
        • Miyamoto H.
        • Ashida N.
        • Katsube T.
        • Tatsumi S.
        • et al.
        Decreased serum sodium levels predict symptomatic vasospasm in patients with subarachnoid hemorrhage.
        J Clin Neurosci. 2017; 46: 118-123
        View in Article
        • Kurokawa Y.
        • Uede T.
        • Ishiguro M.
        • Honda O.
        • Honmou O.
        • Kato T.
        • et al.
        Pathogenesis of hyponatremia following subarachnoid hemorrhage due to ruptured cerebral aneurysm.
        Surg Neurol. 1996; 46: 500-508
        View in Article
        • Berendes E.
        • Walter M.
        • Cullen P.
        • Prien T.
        • Aken H.V.
        • Horsthemke J.
        • et al.
        Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage.
        Lancet. 1997; 349: 245-249
        View in Article
        • See A.P.
        • Wu K.C.
        • Lai P.M.R.
        • Gross B.A.
        • Du R.
        Risk factors for hyponatremia in aneurysmal subarachnoid hemorrhage.
        J Clin Neurosci. 2016; 32: 115-118https://doi.org/10.1016/j.jocn.2016.04.006
        View in Article
        • Hannon M.J.
        • Behan L.A.
        • O'Brien M.M.C.
        • Tormey W.
        • Ball S.G.
        • Javadpur M.
        • et al.
        Hyponatremia following mild/moderate subarachnoid hemorrhage is due to SIAD and glucocorticoid deficiency and not cerebral salt wasting.
        J Clin Endocrinol Metab. 2014; 99: 291-298
        View in Article
        • Parenti G.
        • Cecchi P.C.
        • Ragghianti B.
        • Schwarz A.
        • Ammannati F.
        • Mennonna P.
        • et al.
        Evaluation of the anterior pituitary function in the acute phase after spontaneous subarachnoid hemorrhage.
        J Endocrinol Invest. 2011; 34: 361-365
        View in Article
        • Bales J.
        • Cho S.
        • Tran T.K.
        • Korab G.A.
        • Khandelwal N.
        • Spiekerman C.F.
        • et al.
        The effect of hyponatremia and sodium variability on outcomes in adults with aneurysmal subarachnoid hemorrhage.
        World Neurosurg. 2016; 96: 340-349
        View in Article
        • Eagles M.E.
        • Tso M.K.
        • Macdonald R.L.
        Significance of fluctuations in serum sodium levels following aneurysmal subarachnoid hemorrhage: an exploratory analysis.
        J Neurosurg. 2018; 131: 420-425https://doi.org/10.3171/2018.3.JNS173068
        View in Article
        • Takagi H.
        • Hagiwara D.
        • Handa T.
        • Sugiyama M.
        • Onoue T.
        • Tsunekawa T.
        • et al.
        Diagnosis of central diabetes insipidus using a vasopressin radioimmunoassay during hypertonic saline infusion.
        Endocr J. 2020; 67: 267-274
        View in Article
        • Shibuya M.
        • Suzuki Y.
        • Sugita K.
        • Saito I.
        • Sasaki T.
        • Takakura K.
        • et al.
        Effect of AT877 on cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Results of a prospective placebo-controlled double-blind trial.
        J Neurosurg. 1992; 76: 571-577
        View in Article
        • Shirao S.
        • Yoneda H.
        • Ishihara H.
        • Kajiwara K.
        • Suzuki M.
        A proposed definition of symptomatic vasospasm based on treatment of cerebral vasospasm after subarachnoid hemorrhage in Japan: Consensus 2009, a project of the 25th Spasm Symposium.
        Surg Neurol Int. 2011; 2: 74https://doi.org/10.4103/2152-7806.81968
        View in Article
        • Holm S.
        A simple sequentially rejective multiple test procedure.
        Scand J Stat. 1979; 6: 65-70
        https://www.jstor.org/stable/4615733
        View in Article
        • Boonen E.
        • Vervenne H.
        • Meersseman P.
        • Andrew R.
        • Mortier L.
        • Declercq P.E.
        • et al.
        Reduced cortisol metabolism during critical illness.
        N Engl J Med. 2013; 368: 1477-1488
        View in Article

      17. Lanterna LA, Spreafico V, Gritti P, Prodam F, Signorelli A, Biroli F, et al. Hypocortisolism in noncomatose patients during the acute phase of subarachnoid hemorrhage. J Stroke Cerebrovasc Dis 2013;22(7):e189-e196. doi: 10.1016/j.jstrokecerebrovasdis.2012.11.002.

        View in Article
        • Vergouwen M.D.I.
        • van Geloven N.
        • de Haan R.J.
        • Kruyt N.D.
        • Vermeulen M.
        • Roos Y.B.W.E.M.
        Increased cortisol levels are associated with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
        Neurocrit Care. 2010; 12: 342-345https://doi.org/10.1007/s12028-010-9331-8
        View in Article
        • Zetterling M.
        • Engström B.E.
        • Hallberg L.
        • Hillered L.
        • Enblad P.
        • Karlsson T.
        • et al.
        Cortisol and adrenocorticotropic hormone dynamics in the acute phase of subarachnoid haemorrhage.
        Br J Neurosurg. 2011; 25: 684-692
        View in Article
        • Martin J.
        • Kagerbauer S.M.
        • Schuster T.
        • Blobner M.
        • Kochs E.F.
        • Landgraf R.
        Vasopressin and oxytocin in CSF and plasma of patients with aneurysmal subarachnoid haemorrhage.
        Neuropeptides. 2014; 48: 91-96https://doi.org/10.1016/j.npep.2013.12.004
        View in Article
        • de Oliveira Manoel A.L.
        • Jaja B.N.
        • Germans M.R.
        • Yan H.
        • Qian W.
        • Kouzmina E.
        • et al.
        The VASOGRADE: A Simple Grading Scale for Prediction of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage.
        Stroke. 2015; 46: 1826-1831
        View in Article
        • Isotani E.
        • Suzuki R.
        • Tomita K.
        • Hokari M.
        • Monma S.
        • Marumo F.
        • et al.
        Alterations in plasma concentrations of natriuretic peptides and antidiuretic hormone after subarachnoid hemorrhage.
        Stroke. 1994; 25: 2198-2203
        View in Article
        • Espiner E.A.
        • Leikis R.
        • Ferch R.D.
        • MacFarlane M.R.
        • Bonkowski J.A.
        • Frampton C.M.
        • et al.
        The neuro-cardio-endocrine response to acute subarachnoid haemorrhage.
        Clin Endocrinol (Oxf). 2002; 56: 629-635https://doi.org/10.1046/j.1365-2265.2002.01285.x
        View in Article
        • Audibert G.
        • Steinmann G.
        • de Talancé N.
        • Laurens M.-H.
        • Dao P.
        • Baumann A.
        • et al.
        Endocrine response after severe subarachnoid hemorrhage related to sodium and blood volume regulation.
        Anesth Analg. 2009; 108: 1922-1928
        View in Article
        • Ogura T.
        • Satoh A.
        • Ooigawa H.
        • Sugiyama T.
        • Takeda R.
        • Fushihara G.
        • et al.
        Characteristics and prognostic value of acute catecholamine surge in patients with aneurysmal subarachnoid hemorrhage.
        Neurol Res. 2012; 34: 484-490
        View in Article
        • Fukui S.
        • Katoh H.
        • Tsuzuki N.
        • Ishihara S.
        • Otani N.
        • Uozumi Y.
        • et al.
        Gender disparities in serum electrolytes levels after subarachnoid hemorrhage.
        J Clin Neurosci. 2004; 11: 606-609
        View in Article

      Article info

      Publication history

      Accepted: July 15, 2022
      Received: April 17, 2022

      Identification

      DOI: https://doi.org/10.1016/j.jocn.2022.07.016

      Copyright

      © 2022 Elsevier Ltd. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX