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Plasma atrial natriuretic factor and subarachnoid hemorrhage
M Diringer1, P W Ladenson, B J Stern
1Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21205.
Stroke
|September 1, 1988
Summary
Following subarachnoid hemorrhage, circulating atrial natriuretic factor levels increase significantly. While elevated, this does not solely explain the common hyponatremia observed in patients after brain aneurysm rupture.
Area of Science:
- Neurosurgery
- Endocrinology
- Nephrology
Background:
- Hyponatremia is a frequent complication after aneurysmal subarachnoid hemorrhage.
- The etiology of hyponatremia is debated, with theories including the syndrome of inappropriate antidiuretic hormone secretion and salt wasting.
Purpose of the Study:
- To investigate the role of atrial natriuretic factor (ANF) in the neuroendocrine response to subarachnoid hemorrhage.
- To determine if elevated ANF levels correlate with hyponatremia post-aneurysm rupture.
Main Methods:
- Radioimmunoassay measurement of plasma atrial natriuretic factor in 25 patients with intracranial aneurysms (21 with acute subarachnoid hemorrhage, 4 without).
- Serial measurements were taken post-subarachnoid hemorrhage (Days 1, 3, and 7).
Main Results:
- Plasma ANF concentrations were significantly elevated in patients after subarachnoid hemorrhage compared to baseline.
- ANF levels peaked on Day 3 post-hemorrhage and remained elevated through Day 7.
- Elevated ANF levels were observed in patients with hyponatremia, but not exclusively, suggesting ANF is not the sole cause.
Conclusions:
- Circulating atrial natriuretic factor is elevated following subarachnoid hemorrhage.
- Elevated ANF levels after subarachnoid hemorrhage do not fully explain the associated hyponatremia.