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Serum sodium level on ICU admission was 108 mEq\/L; serum and urine osmolalities were 223 mOsm\/kg and 438 mOsm\/kg, respectively. Her hyponatraemia was initially attributed to syndrome of inappropriate antidiuretic hormone. However, a clinical impression of low volume status raised the suspicion of cerebral salt wasting syndrome. She was managed by infusion of hypertonic saline and fluids for 5\u2009days and discharged from ICU after improvement of her conscious level and normalisation of serum sodium.<\/jats:p>","DOI":"10.1136\/bcr-2020-237027","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T11:55:30Z","timestamp":1615377330000},"page":"e237027","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Distinguishing cerebral salt wasting syndrome and syndrome of inappropriate ADH in a patient with traumatic brain injury"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5328-6039","authenticated-orcid":false,"given":"Hassan","family":"Mohamed","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Pain Management, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt"},{"name":"Department of Anaesthesia and Intensive Care, Leeds Teaching Hospitals, Leeds, West Yorkshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Shorten","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, University College Cork, Cork, Ireland"},{"name":"Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"2025082804461659000_14.3.e237027.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.06.019"},{"key":"2025082804461659000_14.3.e237027.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.2.277"},{"key":"2025082804461659000_14.3.e237027.3","article-title":"Cerebral salt wasting following traumatic brain injury","volume":"2017","author":"Taylor","year":"2017","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2025082804461659000_14.3.e237027.4","first-page":"57","article-title":"A salt-wasting syndrome associated with cerebral disease","volume":"63","author":"Peters","year":"1950","journal-title":"Trans Assoc Am Physicians"},{"key":"2025082804461659000_14.3.e237027.5","doi-asserted-by":"crossref","first-page":"62","DOI":"10.7812\/TPP\/08-066","article-title":"Hyponatremia-what is cerebral salt wasting?","volume":"14","author":"Momi","year":"2010","journal-title":"Perm J"},{"key":"2025082804461659000_14.3.e237027.6","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.surneu.2007.02.051","article-title":"Cerebral salt wasting and elevated brain natriuretic peptide levels after traumatic brain injury: 2 case reports","volume":"69","author":"Lu","year":"2008","journal-title":"Surg Neurol"},{"key":"2025082804461659000_14.3.e237027.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa031994"},{"key":"2025082804461659000_14.3.e237027.8","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.lfs.2004.11.010","article-title":"Cerebral salt wasting in subarachnoid hemorrhage rats: model, mechanism, and tool","volume":"76","author":"Kojima","year":"2005","journal-title":"Life Sci"},{"key":"2025082804461659000_14.3.e237027.9","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s11102-009-0188-9","article-title":"Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage","volume":"12","author":"Kao","year":"2009","journal-title":"Pituitary"},{"key":"2025082804461659000_14.3.e237027.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2009.10.011"},{"key":"2025082804461659000_14.3.e237027.11","unstructured":"American Academy of Family Physicians . 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