Dysautonomia secondary to third ventriculostomy successfully managed with midodrine.


Journal

BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291

Informations de publication

Date de publication:
17 Jun 2020
Historique:
entrez: 20 6 2020
pubmed: 20 6 2020
medline: 10 2 2021
Statut: epublish

Résumé

Hypothalamic lesions can compromise its essential regulatory roles resulting in critical disruption of temperature and blood pressure homoeostasis. We present the case of a 55-year-old woman who had been previously submitted to several neurosurgical procedures aimed at treating idiopathic hydrocephalus. She presented to our department with recurring episodes of hypothermia and wide blood pressure variations, which had been worsening over the last few years. After extensive complementary workup, which excluded new neurological lesions or endocrinological conditions, hypothalamic dysfunction was assumed to be the cause of this syndrome. She was successfully treated with midodrine and on-demand captopril, which resulted in adequate control of her blood pressure. This case highlights the rare and unpredictable consequences of damage to the hypothalamus, depicting the favourable result of a heretofore unpublished medical approach.

Identifiants

pubmed: 32554459
pii: 13/6/e232767
doi: 10.1136/bcr-2019-232767
pmc: PMC7304637
pii:
doi:

Substances chimiques

Midodrine 6YE7PBM15H

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Torcato Moreira Marques (T)

Internal Medicine Department, Hospital de Santa Marta, Lisboa, Portugal torcato.marques@chlc.min-saude.pt.

André Almeida (A)

Internal Medicine Department, Hospital de Santa Marta, Lisboa, Portugal.
NOVA Medica School, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Lisboa, Portugal.

Joana Pinheiro (J)

Endocrinology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal.

Paula Oliveira Nascimento (PO)

Internal Medicine Department, Hospital de Santa Marta, Lisboa, Portugal.

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Classifications MeSH