What Is a Hypothalamic Tumor?

Hypothalamus syndrome is a group of syndromes mainly with endocrine and metabolic disorders, accompanied by autonomic nervous system symptoms and mild neurological and psychiatric symptoms, which are caused by damage to the hypothalamus for various reasons.

Basic Information

English name: hypothalamic syndrome
Visiting department: Internal medicine
Common locations: Hypothalamus
Common causes: Infection, tumor, trauma, congenital disease, degenerative disease, certain drugs, etc.

Common symptoms: Obesity; precocious puberty; amenorrhea, galactorrhea, hyposexuality, impotence; fear of coldness, less sweat, hair loss, myxedema, weakness; drink more, polyuria, etc.

Causes of hypothalamic syndrome

Infection

Encephalitis, tuberculosis, measles, etc.

Tumor

Ectopic pineal tumor, craniopharyngioma, glioma, pituitary tumor, etc.

3. Trauma

Traumatic brain injury, surgery, or radiation therapy involves the hypothalamus area.

4. Congenital diseases

Kallmann syndrome (familial olfactory nerve-sex dysplasia syndrome), Laurence-Moon-Biedl syndrome (sexual juvenile pigmented retinitis, polydactyly syndrome), choroid plexus cysts.

5. Other

Degenerative lesions, certain drugs (such as hibernating spirit, equal blood).

Clinical manifestations of hypothalamic syndrome

Medical history

Have intracranial inflammation, tumors, trauma, surgery, radiation therapy or some congenital diseases.

2. Endocrine dysfunction

Obesity; precocious puberty; amenorrhea, galactorrhea, hyposexuality, impotence; fear of cold, less sweat, hair loss, myxedema, weakness; drink more, and urinate. These changes cannot be explained by single pituitary or target organ damage.

3. Eating Disorders

Gluttony causes obesity, anorexia causes weight loss or bulimia-anorexia alternates.

4. Sleep disorders

Salivation, insomnia, or both.

5. Abnormal body temperature regulation

High, low, or variable body temperature can occur.

6. Mental disorders

Excessive excitement or suppression, impermanence of crying, disorientation, hallucinations, etc.

7. The primary cause of hypothalamic involvement

High intracranial pressure (headache, vomiting) caused by intracranial tumors in women. Loss of vision, visual field defect, coma, etc.

Hypothalamic syndrome examination

Laboratory inspection

(1) Abnormal hormone secretion and corresponding biochemical abnormalities in the hypothalamus, pituitary, and their target glands.

(2) Abnormal hypothalamus and pituitary gland test such as TRH excitation test and GnRH excitation test.

2. Imaging examination

(1) Patients with craniopharyngioma and pineal tumor on plain radiograph of skull can find calcification in the midline position.

(2) CT and MRI examinations are of great value in determining the nature and location of intracranial lesions.

3. Other inspections

(1) Cerebrospinal fluid routine and biochemical help to distinguish inflammation or tumor.

(2) The EEG has reference value for finding the cause.

(3) Cerebral angiography is performed if necessary, such as tumor localization.

Diagnosis of hypothalamic syndrome

Preliminary diagnosis

(1) The premise of diagnosing hypothalamic syndrome is that the hypothalamus can be considered only after the lesions of a single target organ or the pituitary gland and systemic diseases have been excluded.

(2) The most common clinical manifestations of hypothalamic diseases are: sexual dysfunction, diabetes insipidus, obesity, and mental disorders. Therefore, if three of them coexist, the disease should be highly suspected.

(3) Endocrine function and metabolic disorders are the most important manifestations of hypothalamus syndrome, and have the greatest significance for diagnosis. The patient should have a high degree of suspicion when other symptoms (such as neurological manifestations, mental disorders, headaches, and fever) occur at the same time. MRI and CT thin film of the saddle can sometimes show the location and nature of the lesion.

2. Etiology diagnosis

(1) Tumors top the list, the most common of which are craniopharyngioma and ectopic pineal tumor; trauma and congenital disease; inflammatory, granulomatous, and physical factors.

(2) When symptoms of increased intracranial pressure, such as headache, accompanied by abnormal vision or visual field, and progressive diabetes insipidus and sexual dysfunction, the tumor factor should be considered first. MRI and CT sometimes help a lot.

(3) Certain congenital lesions may have chain symptoms: such as loss of smell, malformation, and developmental delay, which may be Kallmann syndrome.

(4) The diagnosis of trauma, drugs and radiation factors depends on detailed medical history.

3. Injury site

The clinical manifestations of patients sometimes reflect the site of hypothalamic lesions, such as impaired preoptic area: autonomic dysfunction; impaired preoptic area of the hypothalamus: high fever; anterior hypothalamus: feeding disorder; Supraoptic nucleus, paraventricular nucleus: diabetes insipidus, idiopathic hypernatremia; damage to the posterior hypothalamus: altered consciousness, lethargy, hypothermia, and decreased motor function.

4. Pathological diagnosis.

Differential diagnosis of hypothalamic syndrome

Disease of endocrine system

Hypopituitary dysfunction, diabetes insipidus, thyroid, adrenal gland, hypogonadism and other diseases have their typical clinical and biochemical changes and can be localized, and the endocrine and metabolic disorders that occur in hypothalamic syndrome are often accompanied by multiple systemic damage. It cannot be explained by a single target organ or a single pituitary lesion.

2. Neurasthenia Syndrome

There may be manifestations of damage to multiple systems throughout the body, but physical examinations, laboratory tests, and special examinations are often not found positive.

3. Identification with primary diseases such as intracranial tumors and inflammation

The above symptoms may show corresponding symptoms and signs, but if a series of changes in the endocrine metabolic system or feeding, temperature, and sleep disorders appear on this basis, it is difficult to explain with the primary disease, the diagnosis of hypothalamic syndrome should be considered.

Hypothalamic Syndrome Treatment

Remove the cause

(1) Stop using drugs that cause hypothalamic syndrome such as hibernating spirit.

(2) Surgical removal of tumors that cause hypothalamic syndrome. If the tumor is too large to be cured and accompanied by increased intracranial pressure, decompression surgery may be used to relieve the symptoms.

(3) Radiotherapy is suitable for tumors sensitive to radiotherapy, such as germ cell tumors.

2. Drug treatment

Visible drug replacement treatments such as hypothyroidism can be used in patients with hypothyroidism, and diabetes insipidus can be used for long-acting diabetes insipidation and coagulation.

3. Symptomatic treatment

(1) Bromocriptine is available for lactating patients.

(2) Patients with intracranial hypertension can use drugs to lower intracranial pressure.

(3) Those with high body temperature can be cooled physically or by drugs, and those with too low temperature can take warming measures.

(4) Patients with impaired thirst need to pay attention to input and output, and maintain a balanced liquid volume.