From the Research
Yes, stroke can cause hypernatremia, which is an elevated sodium level in the blood (typically above 145 mEq/L), as supported by the most recent study 1. This occurs through several mechanisms related to brain injury.
- First, stroke can damage the hypothalamus or pituitary gland, disrupting the production or release of antidiuretic hormone (ADH), leading to diabetes insipidus where the body cannot concentrate urine properly, resulting in excessive water loss and sodium concentration.
- Second, stroke patients often have impaired consciousness or swallowing difficulties (dysphagia), reducing their fluid intake while water losses continue, gradually concentrating sodium levels.
- Additionally, some stroke patients develop a syndrome of inappropriate antidiuretic hormone secretion (SIADH) initially, which may be treated with fluid restriction; if this restriction becomes excessive, hypernatremia can develop. Post-stroke hypernatremia is associated with worse outcomes and higher mortality rates, so careful monitoring of fluid status and electrolytes is essential in stroke management, as highlighted in 1 and 2. Treatment typically involves addressing the underlying cause and carefully administering hypotonic fluids to correct sodium levels gradually, as rapid correction can cause cerebral edema and neurological complications, as noted in 3 and 4. The importance of careful management is further emphasized by the potential risks of diuretic usage following stroke, which can exacerbate dehydration and hypernatremia, as seen in 4. Overall, the relationship between stroke and hypernatremia is complex and multifactorial, requiring a comprehensive approach to management that prioritizes the patient's morbidity, mortality, and quality of life, as supported by the latest evidence 1.