3. Vascular Issues • Aneurysm (especially of nearby arteries like the Circle of Willis) can compress hypothalamic structures. • Cavernous malformations / vascular malformations – tangles of abnormal vessels that sometimes cause pressure or small bleeds. • Stroke (ischemic or hemorrhagic in diencephalic area) – can damage hypothalamic nuclei and disrupt regulation. 4. Inflammatory / Autoimmune • Sarcoidosis – can infiltrate hypothalamic tissue. • Hypophysitis (inflammation of the pituitary stalk/hypothalamus region, sometimes autoimmune or drug-induced). 5. Functional / Non-structural Disorders • Hypothalamic dysfunction without a visible lesion – sometimes due to chronic stress, severe sleep disruption, or metabolic conditions. • This could explain symptoms even if no mass is found on MRI. 꾆 Symptoms That Point Toward Hypothalamic Involvement • Endocrine changes (weight shifts, heat/cold intolerance, abnormal cortisol cycles). • Autonomic issues (heart racing, dizziness, sweats, blood pressure swings). • Sleep/circadian disruption (early AM wake-ups, cortisol surges). • Behavioral/emotional changes (anxiety surges, fatigue).
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