Introduction:
Hyponatremia is a common electrolyte disturbance encountered in the
postoperative period. However, severe hyponatremia, defined as serum
sodium <120 mmol/L, following surgery is
rare.1 If untreated it can lead to serious neurologic
complications including encephalopathy, seizures, and death.
Conversely, a rapid correction of sodium levels may result in a major
neurological sequalae due to osmotic demyelination
syndrome.1 Thus, it is important for perioperative
clinicians to be familiar with the appropriate management of severe
hyponatremia. Here, we present a patient who developed neurological
dysfunction due to severe hyponatremia following carotid endarterectomy
(CEA) surgery. Using this case example, we describe the
pathophysiological mechanisms that place these patients at a higher risk
for the development of this complication and review the clinical
management of severe hyponatremia.
HIPPA Authorization: A written HIPAA authorization consent was
obtained from the patient for the publication of this manuscript.