Acute Salt Poisoning Leading to Subarachnoid Hemorrhage: A Case Report

Area of Science:

• Neurology
• Toxicology
• Internal Medicine

Background:

• Severe hypernatremia is a critical condition often associated with poor neurological outcomes.
• Salt poisoning, particularly from ingesting large volumes of high-sodium substances like soy sauce, can precipitate serious medical emergencies.
• Intracranial hemorrhage, including subarachnoid hemorrhage, is a known but rare complication of severe hypernatremia.

Purpose of the Study:

• To report a case of severe hypernatremia and subarachnoid hemorrhage secondary to massive soy sauce ingestion.
• To illustrate the successful management and favorable neurological outcome following rapid, controlled correction of hypernatremia.
• To highlight the potential for recovery in salt poisoning-induced intracranial hemorrhage.

Main Methods:

• A 51-year-old male patient presented with severe hypernatremia (171 mEq/L) and nonaneurysmal subarachnoid hemorrhage after ingesting 1 liter of soy sauce.
• Treatment involved the administration of 5% dextrose for controlled reduction of serum sodium levels.
• Careful monitoring was implemented to avoid hyperglycemia during the correction process.

Main Results:

• The patient's serum sodium levels were rapidly and effectively corrected.
• Hyperglycemia was successfully avoided throughout the treatment period.
• The patient achieved full neurological recovery, with resolution of symptoms related to hypernatremia and subarachnoid hemorrhage.

Conclusions:

• This case demonstrates that aggressive, yet controlled, correction of severe hypernatremia is feasible and can lead to excellent neurological outcomes, even in the presence of intracranial hemorrhage.
• Salt poisoning is a significant risk factor for both hypernatremia and subsequent neurological complications, including hemorrhage.
• Prompt and appropriate medical intervention can reverse the effects of salt poisoning and improve patient prognosis.