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The Pituitary Gland

The Pituitary Gland

The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.

Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

Cushing Syndrome I: Introduction

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...

Cushing Syndrome II: Pathophysiology

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...

Increased Intracranial Pressure l: Introduction

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...

Increased Intracranial Pressure ll: Pathophysiology

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

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Related Experiment Video

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Hypopituitarism caused by intrasellar aneurysms.

H M Heshmati¹, V Fatourechi, S A Dagam

¹Division of Endocrinology, Metabolism, Nutrition and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.

Mayo Clinic Proceedings

|August 14, 2001

Summary

Intrasellar aneurysms are a rare cause of hypopituitarism, affecting 0.17% of patients. Early diagnosis is crucial for surgical success, as pituitary function often remains permanently impaired after treatment.

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Area of Science:

Neuroendocrinology
Vascular Neurosurgery

Background:

Hypopituitarism can result from various pituitary and suprasellar lesions.
Intrasellar aneurysms are uncommon causes of pituitary dysfunction.

Purpose of the Study:

To determine the prevalence, clinical presentation, and outcomes of hypopituitarism caused by intrasellar aneurysms.
To highlight the importance of preoperative diagnosis for effective surgical management.

Main Methods:

Retrospective review of medical records from 1950 to 1995 at Mayo Clinic.
Analysis of patient data including prevalence, clinical symptoms, diagnostic methods, and surgical outcomes.

Main Results:

Intrasellar aneurysms accounted for 0.17% of hypopituitarism cases (7 out of 4087 patients).
Common deficiencies included adrenal, thyroid, and gonadal axes; all patients experienced visual impairment.
Preoperative diagnosis was achieved in 5 of 7 patients via imaging; surgical outcomes showed no improvement in pituitary function.

Conclusions:

Intrasellar aneurysms are a rare etiology of hypopituitarism, necessitating prompt diagnosis.
Surgical intervention does not typically restore pituitary function, emphasizing the need for long-term management.
Hypopituitarism secondary to intrasellar aneurysms is generally permanent.