[Adipsia and hypernatremia as the first manifestation of hypothalamic astrocytoma. Report of a case and review of the literature].

Adipsia and hypernatremia is a syndrome which can be observed among children and adults with various congenital or acquired diseases of the brain. We can include the primary neoplasms and the metastatic among the causes of this syndrome. We display the case of a 63-year-old man who presented time-space disorientation, loss of memory fixation, visual hallucinations, unstable walking and absence of the voluntary ingestion of liquids. The serum electrolytes showed serum sodium concentration of 188 mEq/l with plasma osmolality above 380 mOs/kg. Both the forced water intake and the intravenous rehydration restored the plasma osmolality and the normal levels of serum sodium. The magnetic resonance (MR) neurohypophyseal area showed a neoformative lesion at the middle line which affected septum ventricular and hypothalamic area. We analyse the pathophysiologic mechanisms, the clinical and laboratory data, as well as the therapeutic and the evolution of the cases which have been published in the literature.