{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:39:14Z","timestamp":1765546754252,"version":"3.37.3"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Variable neurological manifestations and imaging findings have been described in children with severe hypernatremia. We aimed to describe the spectrum of neuroimaging changes in infants with severe hypernatremia.<\/jats:p><jats:p>\n          Methods\u2003This retrospective study included infants with severe hypernatremia (serum sodium &gt;160\u2009mEq\/L), abnormal neurological examination, and an abnormal magnetic resonance imaging (MRI) of the brain over a period of 2 years in a tertiary care hospital. Relevant clinical data, including the feeding practices, clinical features, complications, and biochemical and radiological parameters, were entered in a structured pro forma. MRI findings were classified as vascular (hemorrhages and cerebral sinus venous thrombosis), osmotic demyelination syndrome (pontine and extrapontine myelinolyses), and white matter changes.<\/jats:p><jats:p>\n          Results\u2003The common clinical features in the neonates were poor feeding (n\u2009=\u20094) and decreased urine output (n\u2009=\u20094); the older infants presented with gastrointestinal losses (n\u2009=\u20095). All cases had dehydration with encephalopathy. The patterns of radiological injury were vascular (hemorrhages, n\u2009=\u20095 and venous thrombosis, n\u2009=\u20093), osmotic demyelination (n\u2009=\u20098), and white matter changes (n\u2009=\u20097). Coagulopathy was correlated with the vascular complications (r\u2009=\u20090.8, p\u2009&lt;\u20090.0001); the degree of dehydration was correlated with the venous thrombosis (r\u2009=\u20090.7, p\u2009&lt;\u20090.04) and acute kidney injury (r\u2009=\u20090.8, p\u2009&lt;\u20090.001). Neurological sequelae were seen in four cases and correlated with hypernatremia (r\u2009=\u20090.6, p\u2009=\u20090.03) and hyperosmolarity (r\u2009=\u20090.6, p\u2009=\u20090.03).<\/jats:p><jats:p>\n          Conclusion\u2003Characteristic neuroimaging findings are vascular changes in the form of venous thrombosis and hemorrhages, osmotic demyelination and white matter tract injury, and\/or mostly combinations of these findings. Severe hypernatremia and resulting hyperosmolarity frequently cause neurological sequelae in neonates and infants.<\/jats:p>","DOI":"10.1055\/s-0041-1730938","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T23:00:59Z","timestamp":1625094059000},"page":"316-325","source":"Crossref","is-referenced-by-count":5,"title":["Neuroimaging Spectrum of Severe Hypernatremia in Infants with Neurological Manifestations"],"prefix":"10.1055","volume":"52","author":[{"given":"Arushi Gahlot","family":"Saini","sequence":"first","affiliation":[{"name":"Department of Pediatric, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0113-0486","authenticated-orcid":false,"given":"Sameer","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrit","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhjyot","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkataseshan","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanya","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paramjeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,6,30]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0031-3955(16)36874-2","article-title":"Hypernatremia","volume":"37","author":"S B Conley","year":"1990","journal-title":"Pediatr Clin North 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