Use of statins and outcome of BCG treatment for bladder cancer.

The Authors Reply: We agree with Finucane that it is important to monitor and treat hyponatremia after a ruptured cerebral aneurysm. He cites a study that showed fewer instances of hyponatremia among patients with spontaneous subarachnoid hemorrhage who were treated conservatively than among those who were treated with clipping or coiling.1 The group treated conservatively, however, consisted mostly of patients with subarachnoid hemorrhage in which an aneurysm could not be detected. The natural history of nonaneurysmal subarachnoid hemorrhage usually differs from that of aneurysmal subarachnoid hemorrhage. Hyponatremia is infrequently the cause of significant impairment or death in patients with subarachnoid hemorrhage. For example, one recent multicenter review showed that hyponatremia had no bearing on the outcome 3 months after subarachnoid hemorrhage.2 Torres et al. share their algorithm for screening patients with autosomal dominant polycystic kidney disease. Although the incidence of cerebral aneurysms in the population with this disease is generally thought to be higher than that in the population without this disease, estimates of the prevalence have varied considerably. On the basis of currently available data, the screening approach outlined by Torres and colleagues appears to be reasonable. Whiteley and Al-Shahi point out the importance of the World Federation of Neurosurgical Societies Scale for subarachnoid hemorrhage. More 1.