Cerebral Salt Wasting Syndrome
triad: hypoNa, volume contraction (low CVP), and high urine Na
a/w SAH –>bnp –>salt waste
SIADH is your differential, but SIADH is 2/2 renal retention of free water, so 24hr urine Na is normal in SIADH, normal CVP
DI and primary hyperaldosteronism –> elevated Na
Ref. Miller 8th ed p 2177
Intracranial HTN >15mmHg
SSEPs
-stimulation of peripheral nerves
-ascends ipsilateral dorsal column
-recorded on c/l somatosensory cortex
Hyperventilation lowers ICP
-reduces CBV and CBF
-duration wanes in 6-10hrs
-CBF decreases 2% for every mmHg decrease in PaCO2
-1ml/100g/min CBF increase per 1mmHg increase in Paco2 so since normal CBF is 50ml/100g/min then this is a 2% change
The Ether Binge 
Hey John, this is Allen Cheng… Worked with you yesterday. Thanks for giving me the downloads about the residency program… I set up the OR this morning with what you taught me, attending was pleased. thanks!
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You’re welcome Allen, glad it worked out and great working with you!
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