MECHANISMS THROUGH WHICH HYPERGLYCEMIA WORSENS NEUROLOGICAL OUTCOME

✔️Hyperosmolality 

✔️Lactic acidosis

✔️Alterations in neuronal pH

✔️Increase in excitatory Amino Acids

FACTORS CAUSING FLUID AND ELECTROLYTE DISTURBANCES IN THE NEUROSURGICAL PATIENT

✅POOR ORAL INTAKE LEADING TO DEHYDRATION DUE TO

🔖 Decreased conscious level

🔖 Vomiting

🔖 Bulbar dysfunction 

🔖 Pending surgery 

✅FLUID OVERLOAD DUE TO

🔖overzealous intravenous rehydration 

✅DRUGS

🔖osmotic or loop diuretic therapy as part of the management of raised ICP

✅DISORDERS OF SODIUM-WATER BALANCE ASSOCIATED WITH THE NEUROLOGICAL PATHOLOGY/ SURGERY

🔖Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

🔖Cerebral salt wasting (CSWS) 

🔖Diabetes insipidus