Pituitary apoplexy pathophysiology: Difference between revisions
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Pituitary apoplexy is caused by bleeding into pituitary gland. | Pituitary apoplexy is caused by bleeding into pituitary gland. | ||
Most often, it is seen with a pituitary adenoma. These adenoma's have decreased blood supply and angiogenesis as compared to normal pituitary gland. <ref name="pmid25859802">{{cite journal| author=Oldfield EH, Merrill MJ| title=Apoplexy of pituitary adenomas: the perfect storm. | journal=J Neurosurg | year= 2015 | volume= 122 | issue= 6 | pages= 1444-9 | pmid=25859802 | doi=10.3171/2014.10.JNS141720 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25859802 }} </ref><ref name="pmid5055626">{{cite journal| author=Schechter J| title=Ultrastructural changes in the capillary bed of human pituitary tumors. | journal=Am J Pathol | year= 1972 | volume= 67 | issue= 1 | pages= 109-26 | pmid=5055626 | doi= | pmc=2032586 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5055626 }} </ref> In addition, these vessels have fenestrated endothelium surrounded by a variable number of smooth muscle cells, which are not found in normal pituitary gland<ref name="pmid3417848">{{cite journal| author=Schechter J, Goldsmith P, Wilson C, Weiner R| title=Morphological evidence for the presence of arteries in human prolactinomas. | journal=J Clin Endocrinol Metab | year= 1988 | volume= 67 | issue= 4 | pages= 713-9 | pmid=3417848 | doi=10.1210/jcem-67-4-713 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3417848 }} </ref>. The tumor can outgrow their blood supply and it makes them susceptible to bleeding and infarction. | Most often, it is seen with a pituitary adenoma. These adenoma's have decreased blood supply and angiogenesis as compared to normal pituitary gland. <ref name="pmid25859802">{{cite journal| author=Oldfield EH, Merrill MJ| title=Apoplexy of pituitary adenomas: the perfect storm. | journal=J Neurosurg | year= 2015 | volume= 122 | issue= 6 | pages= 1444-9 | pmid=25859802 | doi=10.3171/2014.10.JNS141720 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25859802 }} </ref><ref name="pmid5055626">{{cite journal| author=Schechter J| title=Ultrastructural changes in the capillary bed of human pituitary tumors. | journal=Am J Pathol | year= 1972 | volume= 67 | issue= 1 | pages= 109-26 | pmid=5055626 | doi= | pmc=2032586 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5055626 }} </ref> In addition, these vessels have fenestrated endothelium surrounded by a variable number of smooth muscle cells, which are not found in normal pituitary gland<ref name="pmid3417848">{{cite journal| author=Schechter J, Goldsmith P, Wilson C, Weiner R| title=Morphological evidence for the presence of arteries in human prolactinomas. | journal=J Clin Endocrinol Metab | year= 1988 | volume= 67 | issue= 4 | pages= 713-9 | pmid=3417848 | doi=10.1210/jcem-67-4-713 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3417848 }} </ref>. The tumor can outgrow their blood supply and it makes them susceptible to bleeding and infarction. Moreover, the bleeding will lead to increase in intrastellar pressure which will compress the adjoining structures which leads to the clinic symptoms of pituiatry apoplexy | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Pituitary apoplexy is caused by bleeding into pituitary gland.
Most often, it is seen with a pituitary adenoma. These adenoma's have decreased blood supply and angiogenesis as compared to normal pituitary gland. [1][2] In addition, these vessels have fenestrated endothelium surrounded by a variable number of smooth muscle cells, which are not found in normal pituitary gland[3]. The tumor can outgrow their blood supply and it makes them susceptible to bleeding and infarction. Moreover, the bleeding will lead to increase in intrastellar pressure which will compress the adjoining structures which leads to the clinic symptoms of pituiatry apoplexy
References
- ↑ Oldfield EH, Merrill MJ (2015). "Apoplexy of pituitary adenomas: the perfect storm". J Neurosurg. 122 (6): 1444–9. doi:10.3171/2014.10.JNS141720. PMID 25859802.
- ↑ Schechter J (1972). "Ultrastructural changes in the capillary bed of human pituitary tumors". Am J Pathol. 67 (1): 109–26. PMC 2032586. PMID 5055626.
- ↑ Schechter J, Goldsmith P, Wilson C, Weiner R (1988). "Morphological evidence for the presence of arteries in human prolactinomas". J Clin Endocrinol Metab. 67 (4): 713–9. doi:10.1210/jcem-67-4-713. PMID 3417848.