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Japanese

HISTOPATHOLOGICAL FINDINGS OF THE PITUITARY GLAND IN CASES OF SUBARACHNOID HEMORRHAGE Tetsuya Morimoto 1 , Toshisuke Sakaki 1 , Kiyoshi Takemura 1 , Yutaka Hori 1 , Shozaburo Utsumi 2 , Kikuo Kyoi 2 , Yoshiro Murata 3 1Department of Neurosurgery, Nara National Hospital 2Department of Neurosurgery, Nara Medical University 3Department of Pathology, Nara Medical University pp.147-153
Published Date 1985/2/1
DOI https://doi.org/10.11477/mf.1406205458
  • Abstract
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Histopathological change of the pituitary gland in cases of the central nervous system disorder, especially in the cases of subarachnoid hemor-rhage, was studied.

Clinical materials were 23 cases who were died from subarachnoid hemorrhage due to aneurysmal rupture in the acute stage. Histopathological change was examined not only of the pituitary gland but also hypothalamus and the change due to in-creased intracranial pressure (midbrain hemor-rhage and uncal herniation). Main histopathological findings of the pituitary gland are anterior pitui-tary necrosis and they are found in 8 cases out of 23 subarachnoid hemorrhage cases (34. 9%).

Histopathological changes in hypothalamus were hemorrhage or infarction, and these changes were present in 16 cases (70%). Eight cases with pitui-tary necrosis had showed hypothalamic lesions. Three cases out of 23 cases (17. 4%) showed mid-brain hemorrhage and uncal herniation and 3 cases out of these 4 cases had anterior pituitary necrosis.

According to the angiographic findings, vaso-spasm tended to be severe and widespread in cases of anterior pituitary necrosis, meanwhile vaso-spasm did not tend to be severe or widespread in cases without anterior pituitary necrosis.

It was suspected that the mechanism of the development of pituitary necrosis is related not only to the circulatory disturbance of the porta] vessels due to mechanical compression on the pituitary stalk and acutely raised intracranial pres-sure at the moment of aneurysmal rupture, but also circulatory disturbance of the portal vessels due to vasospasm.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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