Wilfredo García, Pedro Moromizato, Rafaela Mego, Hernando Rafael, José Rodriguez
CaseRepClinPractRev 2004; 5:481-486
Available online: 2004-04-20
Background: Since 1997 we known that the revascularization in the posterior hypothalamic nuclei can normalize neurogenic hypertension and likewise,experimental and clinical studies suggest that
type 2 diabetes mellitus (DM) is a disorder of the hypothalamus.Case Report: Case 1 was a 75-year-old woman with type 2 DM,vertigo,mild Alzheimer´s disease(AD), olfactory deficit and daytime sleepiness. During 10 years with diabetes,her blood glucose fluctuated between 110 and 240 mg %. Case 2 is a 82-year-old man with a 14-year history of type 2 DM,and lately,he presented motor deficit,bladder dysfunction,arterial hypertension,visual impairment and siallorrhea. His glycemias varied between 115 and 175 mg%. Both patientswere treated with oral hypoglycemic agents. An omental transplantation on the optic chiasma and the carotid bifurcation was performed on both cases.Results: Neurological improvement began since the first days after the operation; especially the mild AD disappeared and neurogenic hypertension was normalized and without antihypertensive medication. Moreover ,they had normal levels of circulating blood glucose and with scarce antidiabetic medication.Conclusions: These neurosurgical findings indicate that ischemic neurons in the anterior hypothalamic nuclei are responsibles at the onset of type 2 DM( mild state ).
Keywords: Cerebral atherosclerosis, Hypothalamic ischemia, Omental transplantation., type 2 diabetes