A 45-Year-Old Man Comes to the Emergency Department After Experiencing

A 45-year-old man comes to the emergency department after experiencing sudden-onset headache with brief loss of consciousness while working in his yard.  CT scan of the brain reveals blood in the basal cistern from a ruptured intracranial aneurysm.  The patient is hospitalized, and endovascular coiling of the aneurysm is performed.  Over the next several days, his symptoms gradually improve but the patient develops worsening hyponatremia.  Which of the following is the most likely cause of this patient's hyponatremia?

A) Defective central thirst regulation
B) Impaired renal concentrating ability
C) Inadequate dietary sodium intake
D) Increased antidiuretic hormone secretion
E) Stress-induced excessive cortisol levels

Correct Answer:

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