1119. Increased Frequency of Hypernatremia in Ruptured Anterior Communicating Artery Aneurysms

Authors: Soren B Jonzzon; Caleb Rutledge, MD; Ethan Winkler, MD, PhD; Lewis Blevins, MD; Adib Abla, MD (San Francisco, CA)

Introduction: Alterations in sodium homeostasis are common after subarachnoid hemorrhage (SAH). While hyponatremia is the most common electrolyte abnormality in SAH, hypernatremia also occurs after SAH. Given the proximity of the anterior communicating artery (ACOM) complex to the hypothalamus and pituitary stalk and fossa, we hypothesized patients with SAH from ruptured ACOM artery aneurysms are at higher risk of hypernatremia and diabetes insipidus (DI) compared to other locations. Methods: We analyzed 200 patients with SAH admitted to the Neurosurgery Service at UCSF between 2012 and 2016. We performed a chi-square analysis to compare rates of hypernatremia between patients with ruptured ACOM aneurysms and those with aneurysms in other locations. Results: 70 patients (70/200 35%) harbored an ACOM aneurysm, while 130 (130/200 65%) were in other locations. The frequency of hypernatremia among patients with ruptured ACOM aneurysms was 25.7% (18/70) compared to 20.8% in other locations respectively (p<0.05). Conclusion: We found a statistically significant association between ruptured ACOM aneurysms and hypernatremia. Patients with an ACOM aneurysm should be screened for hypernatremia so that early recognition and treatment can occur.