Disturbances of the serum electrolytes after surgery of intracranial arterial aneurysms

✓ Of 126 patients operated on for aneurysms of the anterior circle of Willis (pterional microsurgical approach), 44% showed electrolyte disturbances in the postoperative period in spite of excellent clinical results. The majority of cases (26% of the total) presented mild sodium-potassium shifts with no evidence of clinical effects, this type of electrolyte shift was not a complication but a normal consequence of surgery. Patients with preexistent brain damage (7%) showed a tendency for severe sodium-potassium shift and had a bad prognosis. Ten cases showed hyperelectrolytemias (mostly hypernatremias) caused by the following disorders: diabetes insipidus (5), disturbance of thirst center (2), inappropriate antidiuretic hormone (ADH) secretion (1), and 6 patients suffered from various other electrolyte disturbances. The influence of the aneurysm localization is discussed.