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

F. Y. Ismail, A. Szóllics, M. Szólics, N. Nagelkerke, M. Ljubisavljevic

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2225-2232
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume34
Issue number12
DOIs
Publication statusPublished - Dec 2013

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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