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Acta Neurochirurgica

, Volume 97, Issue 3–4, pp 123–127 | Cite as

Diencephalic syndrome following cervical spinal cord trauma

  • I. Iob
  • G. Salar
  • G. Mattisi
  • C. Ori
  • A. Rampazzo
Clinical Articles

Summary

The authors discuss about five cases of diabetes insipidus observed in patients affected by traumatic cervical spine fractures and/ or dislocations, without either evident lesions of the cerebral structures at CT scan examination, or important craniocerebral trauma.

In all patients polyuria and hyperthermia arose some days after the traumatic accident and regressed spontaneously or after exogeneous vasopressin administration.

Vasopressin urinary levels confirmed the presence of a true diabetes insipidus, the origin of which is in largely obscure. A central medullary vasopressin mediated pathway, demonstrated only in experimental animals, may be responsible for such a finding.

Keywords

Diabetes insipidus vasopressin vertebral trauma hypothalamus posterior pituitary 

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References

  1. 1.
    Aubry RH, Nankin HR, Moses AMet al (1965) Measurement of the osmotic threshold for vasopressin release in human subjects, and its modification by cortisol. J Clin Endocrinol Metab 25: 1481–1492PubMedGoogle Scholar
  2. 2.
    Buijs RM (1978) Intra- and extrahypothalamic vasopressin and oxytocin pathways in the rat. Cell Tissue Res 192: 423–435PubMedGoogle Scholar
  3. 3.
    Born JD, Hans P, Smitz Set al (1985) Syndrome of inappropriate secretion of antidiuretic hormone after severe head injury. Surg Neurol 23: 383–387PubMedGoogle Scholar
  4. 4.
    Farrel CA, Staas WE (1986) Diabetes insipidus in a quadriplegic patient. Arch Phys Med Rehab 67: 132–134Google Scholar
  5. 5.
    Hosoya Y, Matsushita M (1979) Identification and distribution of the spinal and hypophysial projection neurons in the paraventricular nucleus of the rat. Exp Brain Res 35: 315–331PubMedGoogle Scholar
  6. 6.
    Kuypers HG, Maisky VA (1975) Retrograde axonal transport of horseradish peroxidase from spinal cord to brain stem cell groups in the rat. Neurosci Lett 1: 9–14Google Scholar
  7. 7.
    Nelson PA, Seif SM, Maroon JCet al (1981) Hyponatremia in intracranial disease: perhaps not the syndrome of inappropriate secretion of antidiuretic hormone. J Neurosurg 55: 938–941PubMedGoogle Scholar
  8. 8.
    Nilaver G, Zimmermann EA, Silverman AJ (1980) Magnocellular hypothalamic projections to the lower brainstem and spinal cord in the rat: immunocytochemical evidence for the predominance of oxytocin-neurophysin system compared to a vasopressin-neurophysin system. Neuroendocrinology 30: 150–158PubMedGoogle Scholar
  9. 9.
    Notman DS, Mortek MA, Moses AM (1980) Permanent diabetes insipidus following head trauma: observation on ten patients and an approach to diagnosis. J Trauma 20: 599–602PubMedGoogle Scholar
  10. 10.
    Pittman QJ, Blume HW, Renaud LP (1981) Connections of the hypothalamoparaventricular nucleus with the neurohypophysis, median eminance, amygdala, lateral septum and midbrain periaqueductal grey. Brain Res 215: 15–28PubMedGoogle Scholar
  11. 11.
    Reppert SM, Artman HG, Swaminathan Set al (1981) Vasopressin exhibits a rhythmic daily pattern in CSF but not in blood. Science 213: 1256–1257PubMedGoogle Scholar
  12. 12.
    Schwartz WB, Bennet W, Curelop Set al (1957) A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med 23: 529–542PubMedGoogle Scholar
  13. 13.
    Silverman AJ, Zimmerman EA (1983) Magnocellular neurosecretory system. Ann Rev Neurosci 6: 357–380PubMedGoogle Scholar
  14. 14.
    Singer I (1981) Differential diagnosis of polyuria and diabetes insipidus. Med Clin North Am 65: 303–320PubMedGoogle Scholar
  15. 15.
    Sofroniew MV, Schrell U (1981) Evidence for a direct projection from oxytocin and vasopressin neurons in the hypothalamic paraventricular nucleus to the medulla oblongata: Immunohistochemical visualization of both the horseradish peroxidase transport and the peptide produced by the same neurons. Neurosci Lett 22: 211–217Google Scholar
  16. 16.
    Swanson LW, Kuypers HG (1980) The paraventricular nucleus: cytoarchitectonic subdivisions and organization of projections to the pituitary, dorsal vagal complex and spinal cord as demonstrated by retrograde fluorescence double labeling methods. J Comp Neurol 194: 555–570PubMedGoogle Scholar
  17. 17.
    Swanson LW, Mc Kellar S (1979) The distribution of oxytocin and vasopressin-stained fibers in the spinal cord of the rat and monkey. J Comp Neurol 188: 87–106PubMedGoogle Scholar
  18. 18.
    White R (1972) Current status of spinal cord cooling. Clin Neurosurg 20: 400–409Google Scholar
  19. 19.
    Zimmermann EA (1981) The organization of oxytocin and vasopressin pathways. In: Martin JB, Reichlin S, Bick KL (eds) Neurosecretion and brain peptides. Raven Press, New York, pp 63–75Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • I. Iob
    • 1
  • G. Salar
    • 1
  • G. Mattisi
    • 1
  • C. Ori
    • 2
  • A. Rampazzo
    • 3
  1. 1.Institute of NeurosurgeryUniversity of PadovaItaly
  2. 2.Institute of AnaesthesiologyUniversity of PadovaItaly
  3. 3.Institute of EndocrinologyUniversity of PadovaItaly

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