Subarachnoid Hemorrhage with Cerebral Salt Wasting Leading to Cerebral Ischemia

Cerebral vasospasm is a well-known complication after aneurysmal subarachnoid hemorrhage. This along with natriuresis in the form of cerebral salt wasting (CSW) leads to intravascular volume depletion, potentiating cerebral edema and leading to cerebral infarction and focal neurological deficit(s). CSW and syndrome of inappropriate antidiuretic hormone (SIADH) have been reported to occur in cerebral pathologies. Hyponatremia resulting from CSW may be difficult to distinguish from SIADH. However, the distinction between them is imperative because treatment is just the opposite. In this manuscript, we report a case of CSW culminating in cerebral vasospasm, cerebral edema, and ischemia that manifested as aphasia during the postoperative period.