Clinical and morphological studies of pituitary and diencephalic space-occupying lesions before and after operation, with special reference to temperature regulation.

In this study investigations are reported which analyze the clinical and morphological results in the treatment of diencephalic tumours. Depending on their location, these tumours are classified according to the extent of hypothalamic compression. The following parameters were studied: body temperature, blood pressure, pulse rate, serum electrolytes, water balance, and serum glucose. Hormonal tests were carried out to detect disturbances of pituitary and diencephalic function. The clinical findings were verified by morphological study of the hypothalamus in serial sections. The study covers 193 patients with sellar and diencephalic tumours. This analysis led to the following conclusions: 1. The postoperative temperature course is a reliable parameter for the diagnosis of diencephalic damage. 2. Diabetes insipidus is evidence of a diencephalic lesion. 3. Disturbances in the regulation of the serum glucose, electrolytes, blood pressure, and pulse rate are signs of a diffuse diencephalic lesion. 4. Endocrinological disturbances in the late phase indicate permanent diencephalic damage. This study indicates that the clinical findings in the acute postoperative period permit evaluation of the extent of the hypothalamic damage. These findings are consistent with Rothballer's observations on the pre-operative evaluation of these tumours.