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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
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Related Experiment Video

Updated: Feb 10, 2026

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Nonfunctioning pituitary adenomas in elderly patients.

Yasuyuki Kinoshita1, Kaoru Kurisu1, Kazunori Arita2

  • 1Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 10, 2018
PubMed
Summary
This summary is machine-generated.

Transsphenoidal surgery (TSS) for nonfunctioning pituitary adenomas (NFPA) in elderly patients is safe, with outcomes comparable to younger patients. Strict adherence to surgical indications is crucial for optimal management.

Keywords:
AgeElder patientsNonfunctioning pituitary adenomaPituitaryTranssphenoidal surgery

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Geriatric Medicine

Background:

  • Recent literature highlights new findings on transsphenoidal surgery (TSS) for pituitary lesions in elderly patients.
  • Nonfunctioning pituitary adenomas (NFPAs) are the most prevalent pituitary adenomas in older individuals, often presenting with mass effect symptoms.

Purpose of the Study:

  • To provide an updated literature review on transsphenoidal surgery (TSS) for nonfunctioning pituitary adenomas (NFPAs) in elderly patients.
  • To aid in the clinical management of nonfunctioning pituitary adenomas (NFPAs) in the geriatric population.

Main Methods:

  • Comprehensive literature search of PubMed and Web of Science databases.
  • Review of studies focusing on transsphenoidal surgery (TSS) for nonfunctioning pituitary adenomas (NFPAs) in elderly patients.

Main Results:

  • Tumor resection and visual improvement rates in elderly patients undergoing TSS for NFPAs are similar to younger patients.
  • Elderly patients may experience more challenges recovering from preoperative hypopituitarism following TSS.
  • Transsphenoidal surgery (TSS) demonstrates low morbidity and mortality rates in the elderly, though risks may increase with advanced age.
  • Surgical consideration for NFPAs in the elderly is reserved for cases with mass effect, not solely hypopituitarism.
  • Non-operative management with MRI surveillance is an option for elderly patients with high ASA scores or no optic pathway involvement.

Conclusions:

  • Transsphenoidal surgery (TSS) is a safe and well-tolerated procedure for treating nonfunctioning pituitary adenomas (NFPAs) in elderly patients.
  • Strict adherence to surgical indications, based on clinical status and radiological findings, is essential for successful outcomes in elderly patients undergoing TSS.