Hypothalamic Lesions Following Closed Head Injury

DIABETES INSIPIDUS is a well recognized sequel of head injury (Porter and Miller, 1946) and the clinical signs and symptoms of hypopituitarism have been described after head injury (Witter and Tascher, 1957). These are well reviewed by the above authors and need not be repeated in the present account, which is concerned with the morbid anatomical findings in the anterior hypothalamus in 106 consecutive autopsies of patients dying soon after severe, acute closed head injuries, i.e. injuries in which the brain was not penetrated by fragments of bone or any foreign substance. The actual demonstration of lesions in the hypothalamus following closed head injury has not been documented in any sizeable autopsy series. In only two instances has the finding of abnormalities in the hypothalamus been correlated with the presence of clinically obvious post-traumatic hypopituitarism. These were patients described by Schereschewsky (1927) in which hemorrhages were described in the floor of the third ventricle, and Henzi (1952) in which there was atrophy of the supraoptic and paraventricular nuclei. There is ample reason why traumatic lesions of the hypothalamus should be of