{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:09:14Z","timestamp":1779433754143,"version":"3.53.1"},"reference-count":106,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T00:00:00Z","timestamp":1459468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>Hyponatremia is frequent in patients suffering from traumatic brain injury, subarachnoid hemorrhage, or following intracranial procedures, with approximately 20% having a decreased serum sodium concentration to &lt;125\u2009mmol\/L. The pathophysiology of hyponatremia in neurotrauma is not completely understood, but in large part is explained by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The abnormal water and\/or sodium handling creates an osmotic gradient promoting the shift of water into brain cells, thereby worsening cerebral edema and precipitating neurological deterioration. Unless hyponatremia is corrected promptly and effectively, morbidity and mortality increases through seizures, elevations in intracranial pressure, and\/or herniation. The excess mortality in patients with severe hyponatremia (&lt;125\u2009mmol\/L) extends beyond the time frame of hospital admission, with a reported mortality of 20% in hospital and 45% within 6 months of follow-up. Current options for the management of hyponatremia include fluid restriction, hypertonic saline, mineralocorticoids, and osmotic diuretics. However, the recent development of vasopressin receptor antagonists provides a more physiological tool for the management of excess water retention and consequent hyponatremia, such as occurs in SIADH. This review summarizes the existing literature on the pathophysiology, clinical features, and management of hyponatremia in the setting of neurotrauma.<\/jats:p>","DOI":"10.1089\/neu.2015.3981","type":"journal-article","created":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T04:26:30Z","timestamp":1444969590000},"page":"615-624","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Hyponatremia in Neurotrauma: The Role of Vasopressin"],"prefix":"10.1177","volume":"33","author":[{"given":"Andrea","family":"Kleindienst","sequence":"first","affiliation":[{"name":"Friedrich-Alexander-University Erlangen-N\u00fcrenberg","place":["Germany"]},{"name":"Department of Neurosurgery, Klinikum Amberg, Amberg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Hannon","sequence":"additional","affiliation":[{"name":"Bantry General Hospital","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buchfelder","sequence":"additional","affiliation":[{"name":"Friedrich-Alexander-University Erlangen-N\u00fcrenberg","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph G.","family":"Verbalis","sequence":"additional","affiliation":[{"name":"Georgetown University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,4,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2006.11.052"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02432.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.11.033"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-8-16"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn061"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.459"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.513"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198206010-00001"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.nrl.0000095258.07720.89"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.44.020193.001445"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(96)00274-4"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02583.x"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-197603000-00002"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcl071"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc7162"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000223440.35642.6E"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2008.072819"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc062683"},{"key":"e_1_3_2_20_2","volume-title":"Consensus statement of the 1st International Exercise-Associated Hyponatremia Consensus Development Conference","author":"Hew-Butler T.","year":"2005","unstructured":"Hew-Butler T., , Almond C., , Ayus J.C., , Dugas J., , Meeuwisse W., , Noakes T., , Reid S., , Siegel A., , Speedy D., , Stuempfle K., , Verbalis J., , and Weschler L.; Exercise-Associated Hyponatremia (EAH) Consensus Panel. (2005). Consensus statement of the 1st International Exercise-Associated Hyponatremia Consensus Development Conference, Cape Town, South Africa 2005. Clin. J. Sport Med. 15, 208\u2013213."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.05.003"},{"key":"e_1_3_2_22_2","first-page":"905","article-title":"Severe hyponatraemia: complications and treatment","volume":"88","author":"Ellis S.J.","year":"1995","unstructured":"Ellis S.J. (1995). Severe hyponatraemia: complications and treatment. QJM, 88, 905\u2013909.","journal-title":"QJM"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-9-200005020-00005"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2010.03.042"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(57)90224-3"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.31.020180.001531"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.256.5055.385"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2002.020818"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0953-8194.2004.01177.x"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.00965.x"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4547(20001115)62:4<480::AID-JNR2>3.0.CO;2-K"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-012-1558-z"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-211-98811-4_41"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(02)39016-2"},{"key":"e_1_3_2_35_2","first-page":"F3","article-title":"Molecular physiology of urinary concentrating mechanism: regulation of aquaporin water channels by vasopressin","volume":"272","author":"Knepper M.A.","year":"1997","unstructured":"Knepper M.A. (1997). Molecular physiology of urinary concentrating mechanism: regulation of aquaporin water channels by vasopressin. Am. J. Physiol., 272, F3\u2013F12.","journal-title":"Am. J. Physiol."},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116881"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065181"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009080857"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-1078"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03530411"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013503126"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.7.JNS13273"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198908243210810"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198908243210802"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-006-0408-5"},{"key":"e_1_3_2_46_2","first-page":"2066","article-title":"Glucocorticoids suppress corticotropin-releasing hormone and vasopressin expression in human hypothalamic neurons","volume":"83","author":"Erkut Z.A.","year":"1998","unstructured":"Erkut Z.A., , Pool C., , and Swaab D.F. (1998). Glucocorticoids suppress corticotropin-releasing hormone and vasopressin expression in human hypothalamic neurons. J. Clin. Endocrinol. Metab., 83, 2066\u20132073.","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI109184"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1980.110"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2008.0601"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0674"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31817603ba"},{"key":"e_1_3_2_52_2","first-page":"57","article-title":"A salt wasting syndrome associated with cerebral disease","volume":"63","author":"Peters J.P.","year":"1950","unstructured":"Peters J.P., , Welt L. G., , Sims E. A. H., , Orloff J., , and Needham J. (1950). A salt wasting syndrome associated with cerebral disease. Trans. Assoc. Am. Physicians, 63, 57\u201364.","journal-title":"Trans. Assoc. Am. Physicians"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.55.6.0938"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0700-5"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1058"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199402000-00010"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410170206"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1159\/000045385"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-0404.2003.00245.x"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7091-0956-4_77"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1555"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01708405"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199808000-00030"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1080\/026990599121016"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2004.02023.x"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000181735.51183.A7"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2476"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02931.x"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm4071480"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hci075"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-3201"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(96)00034-1"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.25.11.2198"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.2.262"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)08093-2"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-70-5-1385"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9504-0"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-009-0188-9"},{"key":"e_1_3_2_79_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2011.06.001"},{"key":"e_1_3_2_80_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03791.x"},{"key":"e_1_3_2_81_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03347460"},{"key":"e_1_3_2_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.11.002"},{"key":"e_1_3_2_83_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3032"},{"key":"e_1_3_2_84_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-307897"},{"key":"e_1_3_2_85_2","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(87)90150-8"},{"key":"e_1_3_2_86_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)01526-0"},{"key":"e_1_3_2_87_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.nrl.0000215741.01699.77"},{"key":"e_1_3_2_88_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-008-9179-3"},{"key":"e_1_3_2_89_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2013.07.006"},{"key":"e_1_3_2_90_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.24.2299"},{"key":"e_1_3_2_91_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/102.2.361"},{"key":"e_1_3_2_92_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90467-R"},{"key":"e_1_3_2_93_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V481522"},{"key":"e_1_3_2_94_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(93)91564-9"},{"key":"e_1_3_2_95_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-291X(05)80177-9"},{"key":"e_1_3_2_96_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(95)00245-L"},{"key":"e_1_3_2_97_2","doi-asserted-by":"publisher","DOI":"10.1006\/exnr.2000.7474"},{"key":"e_1_3_2_98_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000304042.05557.60"},{"key":"e_1_3_2_99_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e31821a6450"},{"key":"e_1_3_2_100_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199311000-00001"},{"key":"e_1_3_2_101_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.254"},{"key":"e_1_3_2_102_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.01027.x"},{"key":"e_1_3_2_103_2","doi-asserted-by":"publisher","DOI":"10.1179\/016164105X17152"},{"key":"e_1_3_2_104_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.06.019"},{"key":"e_1_3_2_105_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm138"},{"key":"e_1_3_2_106_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4082"},{"key":"e_1_3_2_107_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp100260"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2015.3981","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2015.3981","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2015.3981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:55:53Z","timestamp":1779432953000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2015.3981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4]]},"references-count":106,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1089\/neu.2015.3981"],"URL":"https:\/\/doi.org\/10.1089\/neu.2015.3981","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4]]}}}