{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:07:04Z","timestamp":1791648424664,"version":"4.3.4"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The goal of this study was to assess the incidence of symptomatic and occult hyponatremia in patients who had undergone transsphenoidal pituitary surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients who underwent transsphenoidal surgery at the University of Southern California University Hospital between 1997 and 2004 had serum sodium levels drawn on an outpatient basis on postoperative Day 7. Patient records were retrospectively reviewed to determine the incidence of, and risk factors for, symptomatic and asymptomatic hyponatremia.<\/jats:p>\n<jats:p>Two hundred forty-one patients had routine serum sodium levels drawn as outpatients on postoperative Day 7. Twenty-three percent of these patients were found to be hyponatremic (Na \u2264 135 mEq\/L). The overall incidence rate of symptomatic hyponatremia in the 241 patients was 5%. The majority of hyponatremic patients (80%) remained asymptomatic, whereas 20% became symptomatic. In patients with symptomatic hyponatremia, the mean sodium level at diagnosis was 120.5 mEq\/L, compared with 128.4 mEq\/L in asymptomatic, hyponatremic patients (p &lt; 0.0001). Female patients were more likely to develop hyponatremia than male patients (33% compared with 22%, p &lt; 0.03). Fifty-two percent of patients who had transient diabetes insipidus (DI) early in their postoperative course subsequently developed hyponatremia, compared with 21% of those who did not have DI (p &lt; 0.001). Patient age, tumor type, and tumor size did not correlate with development of delayed hyponatremia. Outpatients with moderately and severely low sodium levels were 5 and 12.5 times more likely, respectively, to be symptomatic than were patients with mild hyponatremia.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Delayed hyponatremia occurs more frequently than was previously suspected in patients who have undergone transsphenoidal surgery, especially in female patients and those who have previously had transient DI. The majority of hyponatremic patients remain asymptomatic. Obtaining a serum sodium value on an outpatient basis 1 week after pituitary surgery is helpful in recognition, risk stratification, and subsequent intervention, and may prevent potentially serious complications.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2007.106.1.66","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:45:25Z","timestamp":1201178725000},"page":"66-71","source":"Crossref","is-referenced-by-count":107,"title":["Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery"],"prefix":"10.3171","volume":"106","author":[{"given":"Gabriel","family":"Zada","sequence":"first","affiliation":[{"name":"1Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"1Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Fishback","sequence":"additional","affiliation":[{"name":"1Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Singer","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology and Metabolism, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Weiss","sequence":"additional","affiliation":[{"name":"1Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1060066","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1227\/00006123-198604000-00015","article-title":"Cerebral salt wasting after pituitary exploration and biopsy: case report","volume":"18","year":"1986"},{"key":"b2-1060066","series-title":"Neth J Med","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/S0300-2977(01)00087-0","article-title":"Hyponatremia in intracranial disorders","volume":"58","year":"2001"},{"key":"b3-1060066","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1056\/NEJM198407053110107","article-title":"Inappropriate secretion of antidiuretic hormone after transsphenoidal surgery for pituitary tumors","volume":"311","year":"1984"},{"key":"b4-1060066","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3171\/jns.1982.56.1.0033","article-title":"Transsphenoidal microsurgery for prolactin-secreting pituitary adenomas","volume":"56","year":"1982"},{"key":"b5-1060066","series-title":"Endocrinology","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1210\/endo-20-6-762","article-title":"The effect of interruption of the supraoptic-hypophyseal tracts on the antidiuretic, pressor and oxytocic activity of the posterior lobe of the hypophysis","volume":"20","year":"1936"},{"key":"b6-1060066","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1046\/j.1365-2265.1999.00666.x","article-title":"Prevalence, predictors and patterns of postoperative polyuria and hyponatraemia in the immediate course after transsphenoidal surgery for pituitary adenomas","volume":"50","year":"1999"},{"key":"b7-1060066","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3171\/jns.1995.83.2.0363","article-title":"Delayed hyponatremia after transsphenoidal surgery for pituitary adenoma. 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