PT  - JOURNAL ARTICLE
AU  - Torcato Moreira Marques
AU  - André Almeida
AU  - Joana Pinheiro
AU  - Paula Oliveira Nascimento
TI  - Dysautonomia secondary to third ventriculostomy successfully managed with midodrine
AID  - 10.1136/bcr-2019-232767
DP  - 2020 Jun 01
TA  - BMJ Case Reports
PG  - e232767
VI  - 13
IP  - 6
4099  - http://casereports.bmj.com/content/13/6/e232767.short
4100  - http://casereports.bmj.com/content/13/6/e232767.full
SO  - BMJ Case Reports2020 Jun 01; 13
AB  - 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the rare and unpredictable consequences of damage to the hypothalamus, depicting the favourable result of a heretofore unpublished medical approach.