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Chronic and Sustained Hypernatremia, Absence of Thirst, Diabetes Insipidus, and Adrenocorticotrophin Insufficiency Resulting from Widespread Destruction of the Hypothalamus

Ann Intern Med. 1962;56(1):131-140. doi:10.7326/0003-4819-56-1-131
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Locations within the central nervous system of centers influencing the metabolism of water and electrolytes have been long recognized (1-5). Consequently, clinical disturbances in solute and water balance have frequently been attributed causally to various intracranial lesions (6-11). Diabetes insipidus is by far the most frequently diagnosed of such disturbances, possibly because of the vulnerable anatomy of the supraoptico-neurohypophyseal system and the ease with which the clinical manifestations of antidiuretic hormone (ADH) insufficiency are recognized. However, other clinical entities involving water and mineral metabolism have been reported. Intracranial disease resulting in the excessive secretion of antidiuretic hormone (11), renal salt


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