Hyponatremia, Cerebral Edema, and Noncardiogenic Pulmonary Edema in Marathon Runners

Article Abstract:

Healthy marathon runners can develop a potentially fatal sequence of physiological events beginning with hyponatremia, a decrease of sodium levels in the blood. This can influence the onset of cerebral and pulmonary edema (fluid in the tissues). This may be easily treated with a solution containing a high concentration (1% to 15%) of sodium chloride. Records were analyzed of seven marathon runners with a history of using nonsteroidal anti-inflammatories, all of whom collapsed after competition and were admitted with pulmonary edema. Examination showed pulmonary edema with no heart abnormalities, and cerebral edema, both of which resolved as sodium levels rose.

Health aspects, Cerebral edema, Pulmonary edema, Marathon running

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Fatal central diabetes mellitus and insipidus resulting from untreated hyponatremia: a new syndrome

Article Abstract:

Hyponatremia, a condition of extremely low blood levels of sodium, commonly occurs in hospitalized patients and may result in disease and death. The course and outcome of hyponatremia were shown to be poor, particularly among women of child-bearing age. One study showed that 40 healthy women who developed hyponatremia after surgery either died or suffered permanent brain damage. Eleven cases are described of healthy young women with an average age of 30 years, who had normal blood sodium levels before undergoing surgery. At around 32 hours after waking from surgery, the patients went from alertness to respiratory arrest, or cessation of breathing, within one hour of waking. Blood sodium levels had decreased, resulting in excessive urination. Within the next 51 hours, sodium and glucose in the blood increased to abnormally high levels. The patients did not regain consciousness and died. Autopsy showed fluid accumulation within the brain, brain protrusion, and tissue deterioration in the pituitary, medulla, and hypothalamus. Because the patients had fixed, dilated pupils shortly following respiratory arrest, they were diagnosed as brain dead. However, pressure on the oculomotor nerve which controls eye movement may have caused this reaction, and some patients diagnosed as brain dead may have been saved. The findings show that untreated hyponatremia may progress to fluid accumulation within the brain, protrusion of the brain, and deterioration of the pituitary and hypothalamus, resulting in high blood glucose levels and excessive urination, characteristic of diabetes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Prognosis, Diabetes, Diabetes mellitus, Sodium in the body, Sodium (Nutrient), Diabetes insipidus

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Postoperative hyponatremic encephalopathy in menstruant women

Article Abstract:

A study of patients with postoperative hyponatremic encephalopathy found that menstruant women - women of childbearing age - have more than 20 times the risk of death or permanent brain damage compared with men or postmenopausal women. Hyponatremia occurs when the body's sodium level drops, and it is a common complication following surgery. It can induce hyponatremic encephalopathy, a kind of brain disease. Of 76,678 consecutive surgical patients, 65 developed hyponatremic encephalopathy and 674 had hyponatremia without encephalopathy. Women and men were equally at risk of developing postoperative hyponatremia and hyponatremic encephalopathy. However, of the 34 patients who had permanent brain damage or died, 33 were women. Twenty-five, or 76%, of those women were menstruant. These findings indicate menstruant women have the greatest risk of hyponatremic encephalopathy after surgery.

Patient outcomes, Mortality, Menstruation, Encephalopathy

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