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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research
Sony
Department of Anesthesiology and Intensive Therapy, Arifin Achmad Regional General Hospital, Pekanbaru, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Hyponatremia After Intracranial Hemorrhage: Cerebral Salt Wasting Syndrome (CSWS) or The Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)? Wan Novriza Wijaya; Novita Anggraeni; Sony; Andrea Valentino
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1174

Abstract

Background: Hyponatremia is a common electrolyte disorder encountered in neurosurgical patients, often associated with significant morbidity and mortality. This case report highlights the importance of recognizing and appropriately managing cerebral salt wasting syndrome (CSWS), a rare but important cause of hyponatremia in neurosurgical patients, often following intracranial hemorrhage (ICH). Distinguishing CSWS from the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is crucial for appropriate management. Case presentation: A 56-year-old male with a history of hypertension and diabetes mellitus presented with sudden-onset left-sided weakness and decreased consciousness following an ICH. He underwent a ventriculoperitoneal (VP) shunt placement for hydrocephalus. Post-operatively, he developed hyponatremia with elevated urine sodium levels and hypovolemia, suggestive of CSWS. The patient was treated with fluid replacement therapy, including hypertonic saline, and desmopressin, resulting in improvement in his hyponatremia. Conclusion: CSWS is an important cause of hyponatremia in neurosurgical patients. Prompt diagnosis and appropriate management, including fluid replacement and potentially desmopressin, can improve patient outcomes. This case underscores the need for a high index of suspicion for CSWS in neurosurgical patients presenting with hyponatremia and highlights the importance of careful monitoring and individualized treatment strategies.
Successful Anesthetic Management of a Cesarean Section in a Patient with Cardiomyopathy and Cardiogenic Shock: A Case Report Alta Ikhsan Nur; Nopian Hidayat; Novita Anggraeni; Sony
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1230

Abstract

Background: Cardiomyopathy in pregnancy is a rare but serious condition that can lead to significant maternal and fetal morbidity and mortality. Anesthetic management of these patients is challenging due to the complex interplay of physiological changes and the potential for hemodynamic instability. This case report describes the successful anesthetic management of a cesarean section in a patient with cardiomyopathy and cardiogenic shock. Case presentation: A 29-year-old woman with cardiomyopathy and cardiogenic shock presented for emergency cesarean section at 36-37 weeks gestation. She had a history of global hypokinetic, left ventricular and atrial dilatation, and an ejection fraction (EF) of 32%. She was also in atrial fibrillation. Epidural anesthesia was selected due to its lower risk of complications compared to general anesthesia. The patient was carefully monitored throughout the procedure, and her hemodynamics were maintained with a combination of fluids and inotropes. The surgery was successful, and the patient delivered a healthy baby boy. Conclusion: This case report demonstrates that successful anesthetic management of cesarean section is possible in patients with cardiomyopathy and cardiogenic shock. Careful planning, close monitoring, and a multidisciplinary approach are essential for a positive outcome.
Co-Authors Alta Ikhsan Nur Nopian Hidayat Novita Anggraeni Valentino, Andrea Wan Novriza Wijaya