Hypothalamic damage is one of the most serious brain damages and patients are critically ill. The mortality rate is high, the prognosis is poor, and there are fewer clinical cases. Most cases of hypothalamic damage are often combined with other parts of the brain due to the heavy violence and complex mechanism of injury, and the clinical manifestations are often masked by the signs and symptoms of other brain injuries, so how to improve their diagnosis and success rate of treatment is a problem of concern to the majority of clinicians. The diagnosis of hypothalamic damage is based on the following: 1, sleep and consciousness disorders. 2.Disorders of thermoregulation. 3, disorders of water and salt metabolism, such as uremia, water retention, water intoxication and central hypernatremia syndrome. 4, acute upper gastrointestinal bleeding, some reports combined with hypothalamic damage in the incidence of upper gastrointestinal bleeding up to 90%. There is no uniform understanding about the mechanism of upper gastrointestinal bleeding, but autonomic dysfunction undoubtedly plays a leading role. 5. Hyperosmolar non-ketotic diabetic coma with laboratory tests; blood glucose >33 mmol-l-1 and negative or weakly positive urinary ketones. At present, there is no clinical breakthrough in the treatment of hypothalamic damage. The key to improve the efficacy of hypothalamic damage is to prevent and control intracranial hematoma and cerebral edema to the increase in intracranial pressure, but also to prevent and control secondary damage to the hypothalamus, and its treatment should be based on comprehensive treatment principles.