2022 Feb 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.
Cerebral salt wasting (CSW) is a potential cause of hyponatremia in the setting of disease of the central nervous system (CNS). Cerebral salt wasting is characterized by hyponatremia with elevated urine sodium and hypovolemia. In the current literature, professionals debate if cerebral salt wasting is a distinct condition or a special form of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is important to distinguish between cerebral salt wasting and SIADH as the 2 are treated with opposite treatment strategies. For cerebral salt wasting the patient is given fluids and sodium supplementation. For SIADH the patient is fluid restricted. Cerebral salt wasting tends to resolve within weeks to months after onset but can remain a chronic issue. Leading theories for the pathophysiology of cerebral salt wasting include the release of brain natriuretic peptide (BNP) or damage to the hypothalamus with subsequent disorder sympathetic system.