Severe hyponatremia following carotid artery stenting: A case report and literature review
Main Article Content
Abstract
Introduction: Severe hyponatremia following carotid endarterectomy or carotid artery stenting is a rare but potentially life-threatening complication. Its clinical presentation often mimics cerebrovascular events, leading to diagnostic delays.
Case Presentation: A 70-year-old male with 80% stenosis of the right internal carotid artery underwent successful carotid artery stenting. On postoperative day 3, he developed severe headache, drowsiness, and spatiotemporal disorientation. Brain CT and MRI showed no acute abnormalities. Laboratory investigations revealed profound hyponatremia (sodium 102 mmol/L), reduced serum osmolality (202 mOsmol/L), and elevated urinary sodium (58 mEq/L), consistent with SIADH, potentially compounded by thiazide diuretic (Indapamide) use. Treatment with hypertonic saline infusion and fluid restriction resulted in complete clinical recovery within seven days.
Conclusion: Hyponatremia should be considered in the differential diagnosis of postprocedural neurological deterioration following carotid interventions. Routine electrolyte monitoring, particularly in elderly patients on diuretic therapy, may enable early diagnosis and improve outcomes.
Keywords
hyponatremia, carotid artery stenting, SIADH, thiazide diuretics, postprocedural neurological deterioration
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References
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