Pituitary and Hypothalamic Disorders

Abstract

It has been well established in recent years that traumatic haemorrhage and infarction in the supra-optic region of the hypothalamus are almost invariable findings in patients who have died as a result and within a few days of their head injuries and they are commonly seen also in the adjacent infundibular region. The extent to which these lesions, or rather lesser damage in the same areas, is likely to result in disordered pituitary and hypothalamic function in the long-term amongst those who survive does not appear to have been studied systematically before. It is clear, however, that in those who survive severe head injury, damage to the hypothalamus must have been relatively common judged by the frequency with which hyperphagia and polyuria occur. Less certainly, the post-traumatic electrolyte imbalances, particularly of sodium and chloride ions, may be due to impaired production of the peptide releasers of corticotrophin from supra-optic and paraventricular nuclei. The occasional case of acute and otherwise unexplained hypotension within days of the injury, which appears to respond to treatment with hydrocortisone also raises the possibility of impaired hypothalamo-hypophyseal function.