Background: Experimental and clinical studies has showed for years that lesions involving the hypothalamus may lead to obesity or to a cessation of eating. The main of our report was to determine the cause of obesity in two patients who suffered of essential arterial hypertension (EAH).
Case report: The patients with severe EAH and obesity received an omental transplantation of the left and right anterior perforated space, respectively. Neurological examination of the first patient was normal, whereas the last case had a lacune in the right putamen and a small ischemic infarct in the posterior limb of the internal capsule. In both of them patients EAH was normalized after surgery and without antihypertensive medication. Moreover, they presented loss of body weight and without no food restriction.
Conclusions: These clinical results indicate that ischemic neurons in the posterior hypothalamic nuclei are responsibles of neurogenic hypertension, and the ischemia in the lateral hypothalamic zones is related with obesity. By contrast to this, its revascularization can normalize or improve both diseases.

Keywords: essential arterial hypertension, Obesity, omental transplantation, Weight Loss