Background: Hypothalamic hypodipsic syndrome is a rare condition, secondary to a defect in hypothalamic osmoreceptors that leads to impairment of water homeostasis and chronic hyperosmolality. It is frequently associated with defective osmoregulated vasopressin secretion and diabetes insipidus, and the combination results in a greater risk of hypernatremia. The principles of management consist of regulating vasopressin and water intake in relation to changes in daily body weight. Methods and Results: This case report concerns a patient who, after a postoperative cerebral infarction, developed an extensive hypothalamic syndrome including hypodipsic hypernatremia, diabetes insipidus, hyperthermia, profound short-term memory loss and initial severe anorexia, followed by hyperphagia with an inability to maintain body weight. Conclusion: The management of fluid balance proved extremely difficult in this amnesic patient, where weight alone was not sufficient to monitor water intake.

Baylis PH, Thompson CJ: Osmoregulation of vasopressin secretion and thirst in health and disease. Clin Endocrinol 1988;29:549–576.
Ball SG, Vaidja B, Baylis PH: Hypothalamic adipsic syndrome: diagnosis and management. Clin Endocrinol 1997;47:405–409.
Verbalis JG: Disorders of water homeostasis. Best Pract Res Clin Endocrinol Metab 2003;17:471–503.
Vokes TJ, Robertson GL: Disorders of antidiuretic hormone. Endocrinol Metab Clin North Am 1988;17:281–299.
Robertson GL, Aycinena P, Zerbe RL: Neurogenic disorders of osmoregulation. Am J Med 1982;72:339–353.
Daniel PM: The blood supply of the hypothalamus and pituitary gland. Br Med Bull 1966;22:202–208.
Nguyen BN, Yablon SA, Chen CY: Hypodipsic hypernatremia and diabetes insipidus following anterior communicating artery aneurysm clipping: diagnostic and therapeutic challenges in the amnesic rehabilitation patient. Brain Inj 2001;15:975–980.
Landolt AM, Yasargil MG, Krayenbuhl H: Disturbances of the serum electrolytes after surgery of intracranial arterial aneurysms. J Neurosurg 1972;37:210–218.
McIver B, Connacher A, Whittle I, Baylis P, Thompson C: Adipsic hypothalamic diabetes insipidus after clipping of anterior communicating artery aneurysm. Br Med J 1991;303:1465–1467.
McMahon AJ: Diabetes insipidus developing after subarachnoid haemorrhage from an anterior communicating artery aneurysm. Scott Med J 1988;33:208–210.
Takaku A, Shindo K, Tanaka S, Mori T, Suzuki J: Fluid and electrolyte disturbances in patients with intracranial aneurysms. Surg Neurol 1979;11:349–356.
Toni R, Malaguti A, Benfenati F, Martini L: The human hypothalamus: a morpho-functional perspective. J Endocrinol Invest 2004;27:73–94.
Druce M, Bloom SR: The regulation of appetite. Arch Dis Child 2006;91:183–187.
Lopez-Capape M, Golmayo L, Lorenzo G, Gallego N, Barrio R: Hypothalamic adipic hypernatraemia syndrome with normal osmoregulation of vasopressin. Eur J Pediatr 2004;163:580–583.
Pearce SH, Argent NB, Baylis PH: Chronic hypernatremia due to impaired osmoregulated thirst and vasopressin secretion. Acta Endocr 1991;125:234–239.
Green RP, Landt M: Home sodium monitoring in patients with diabetes insipidus. J Pediatr 2002;141:618–624.
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