Hypothalamic damage

Introduction Hypothalamic injury refers to a special clinical syndrome that occurs directly in the lower part of the thalamus due to a skull base fracture or a violent blow to the skull during the process of craniocerebral injury. The hypothalamus is an important subcortical center of the autonomic nervous system, which is closely related to internal organs, endocrine, material metabolism, thermoregulation, and maintenance of consciousness and sleep. Therefore, the clinical manifestations of the hypothalamic injury are often severe. There are fewer lesions in the lower hypothalamus, mostly associated with severe brain contusion and/or brain stem injury.

Cause

The lower part of the thalamus is deep above the skull of the skull. Therefore, the direction of violence directly or indirectly through the lower part of the thalamus may cause local damage. In addition, this area can also be involved when the cerebellum is undercut.

Pathogenesis:

Usually, if the skull base fracture crosses the saddle or its vicinity, it often causes damage to the hypothalamus. When severe impact injury or hedging brain injury causes the bottom of the brain to slide back and forth along the vertical axis, it can also cause damage to the hypothalamus, and often involves the pituitary stalk and pituitary. The pathology of the lesion is mostly focal hemorrhage, edema, ischemia, Softening and necrosis of nerve cells, occasionally visible pituitary stalk rupture and pituitary hemorrhage.

an examination

Related inspection

Brain CT examination brainstem reflex examination brain MRI examination brain ultrasound examination

The isolated and limited primary damage of the hypothalamus is extremely rare. In the process of trauma to the skull, multiple sites often occur. Therefore, the diagnosis of hypothalamic injury is often interfered with by other brain damage. In clinical practice, With one or two manifestations of subthalamic injury, it is necessary to have the possibility of injury to the hypothalamus, especially when there is a skull base fracture in the saddle area and nearby, it should be more vigilant.

Differential diagnosis

Interbrain seizures: also known as posterior cerebral episodes or inter-brain epilepsy, which are a kind of facial flushing, sweating, palpitations, tearing, salivation, tremors and gastrointestinal discomfort. Each episode lasts for a few minutes to 1 ~ 2 hours, but no convulsions, occasionally urine.

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