Relationship of serum sodium level with cerebral edema and prognosis in patients with spontaneous intracerebral hemorrhage

Objective To investigate the association of serum sodium level with cerebral edema and prognosis in patients with spontaneous intracerebral hemorrhage. Methods We prospectively studied 90 patients with spontaneous intracerebral hemorrhage within 24 hours from onset of symptoms. According to the target value of serum sodium level, the patients were divided into 3 groups, relatively low-sodium group (135-140 mmol/L), relatively high-sodium group (140-145 mmol/L), absolute high-sodium group ( 145-155 mmol/L)(n=30 for each). National institutes of health stroke scale (NIHSS), Glasgow coma score (GCS), and blood tests were measured within 24 hours from onset. Hematoma volumes, edema volumes, liver and kidney function were measured within 24 hours, 3 days, 7 days after onset. Modified rankin scale (MRS) were measured at 90 days to assess the recovery of neurological function. Modified rankin scale score ≤ 2 was considered as good outcome. Results The edema volume was smaller in absolute high-sodium group than in relatively low-sodium group and relatively high-sodium group 〔(25.37±26.54) ml vs. (55.21±58.21) ml, (59.48±55.84) ml, F=1.492, P=0.023〕. The percentage of patients with MRS score ≤2 was 70% in absolute high-sodium group, which had a better prognosis as compared with relatively low-sodium and relatively high-sodium group (both P<0.05). The hematoma volume had no significant difference among the three groups. Conclusions The appropriate increase in serum sodium level is safe, which could reduce cerebral edema and get a better prognosis. Key words: Cerebral hemorrhage; Edema; Sodium