Hypothalamic Damage: Multisystem Consequences

The hypothalamus (4 cm³) integrates endocrine, autonomic, and behavioral regulation. Damage causes diverse syndromes:

Tumor (craniopharyngioma, glioma), trauma, surgery, radiation, vascular (aneurysm), infection, infiltration (sarcoid, Langerhans).

Management targets specific deficits (hormone replacement, cooling/heating, sleep hygiene, behavioral support).

Function	Deficit
Hormonal (pituitary control)	Diabetes insipidus (ADH), hypopituitarism (ACTH, TSH, LH/FSH, GH), hyperprolactinemia
Thermoregulation	Poikilothermia, hyper/hypothermia
Sleep-wake	Insomnia, hypersomnia, circadian disruption
Energy balance	Hyperphagia/obesity (VMH lesion) or anorexia (LH lesion)
Emotion/behavior	Rage, placidity, sexual behavior changes
Memory	Mammillary body involvement → Korsakoff-like amnesia