Selective traumatic infarction of the human anterior hypothalamus. Clinical anatomical correlation.

A case of assult with bilateral manual avulsion of the eyes was followed by highly selective infarction of the anterior hypothalamus. The hypothalamic infarction occurred as a result of avulsion of part of the optic chiasm together with the anterior perforating arteries passing through it; Following this assault, symptoms of hypothalamic dysfunction included altered thermoregulation, alternating diabetes insipidus, and inappropriate antidiuretic hormone (ADH) secretion, altered patterns of sleep and arousal, and changing cardiac arrhythmias. The case casts light upon the vascular supply of the human hypothalamus and on the degree of localization existing for various hypothalamic functions.