NECROSIS OF ANTERIOR PITUITARY IN HUMANS .2.

In this review, various aspects of human adenohypophysial necrosis have been discussed. Necrosis of the anterior pituitary is not so rare as was previously assumed. It occurs most frequently in women suffering from severe circulatory failure due to massive obstetrical haemorrhage, but it can also be associated with various other illnesses (diabetes mellitus, shock, epidemic haemorrhagic fever, increased intracranial pressure, injury of the hypophysial stalk, etc.). There is no doubt that ischaemia is the immediate cause of the necrosis; however, the processes leading to the arrest of the pituitary circulation are not definitely known. The most probable explanation is Sheehan’s assumption, according to which, vasospasm plays an important role in the reduction of pituitary blood flow. Infarction occurs in the anterior lobe as a result of the ischaemia, and the necrotic area is later replaced by a fibrous scar. If the necrosis is extensive and the patients survives the acute stage, hypopituitarism with its characteristic clinical symptoms develops. © 1969 S. Karger AG, Basel.