RT Book, Section A1 Edwards, Nancy J. A1 Lee, Kiwon A2 Lee, Kiwon SR Print(0) ID 1143958250 T1 Endocrine Disorders in Critical Illness T2 The NeuroICU Book, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071841443 LK neurology.mhmedical.com/content.aspx?aid=1143958250 RD 2024/03/29 AB A 40-year-old woman presents with a sudden, severe, thunderclap headache. A CT scan and a CT angiogram are obtained which reveal diffuse subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm. The aneurysm is successfully coiled. Five days later, the patient becomes progressively confused. Transcranial Doppler sonography is within normal limits, and a repeat CT angiogram is negative for any significant vessel narrowing suggestive of vasospasm. Laboratory tests reveal a serum sodium concentration of 128 mEq/L. Salt tablets are initiated and titrated higher, but the patient’s sodium remains mildly low. A continuous infusion of 3% sodium chloride is begun, and the patient’s sodium normalizes. Within several days, she is weaned from the continuous infusion and is subsequently discharged home with salt tabs and a scheduled taper.