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Pituitary infarction

Definition

Pituitary infarction is the death of an area of tissue in the pituitary gland, a small gland joined to the hypothalamus (part of the brain). The pituitary produces many of the hormones that control essential body processes.

Alternative Names

Pituitary apoplexy

Causes, incidence, and risk factors

Pituitary infarction is most commonly caused by bleeding due to a noncancerous tumor of the pituitary. When this bleeding occurs in a woman during or right after childbirth, it is called Sheehan syndrome .

Risk factors for pituitary infarction include:

  • Bleeding disorders
  • Diabetes
  • Head injury
  • Radiation to the pituitary gland
  • Use of a breathing machine

However, in most cases, the cause is not clear.

Symptoms

Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening.

Symptoms usually include:

Less commonly, pituitary dysfunction may appear more slowly. In Sheehan syndrome, for example, the first symptom may be a failure to produce milk caused by a lack of the hormone prolactin.

Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:

When the posterior pituitary is involved (rare), symptoms may include:

  • Failure of the uterus to contract as needed to give birth to a baby (in women)
  • Failure to produce breast milk (in women)
  • Uncontrolled urination

Signs and tests

Signs of acute pituitary infarction may include:

Signs of chronic pituitary insufficiency include:

  • Growth hormone deficiency
  • Hypoadrenalism
  • Hypothyroidism

Tests may include:

  • Eye exams
  • or MRI

Blood tests will be done to check levels of:

Treatment

Treatment for acute infarction may require surgery to relieve pressure on the pituitary and improve vision symptoms. Severe cases need emergency surgery.

Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential. Other hormones will be replaced, including:

  • Sex hormones (estrogen/testosterone)
  • Thyroid hormone

Evidence is also growing for the need to replace growth hormone.

Support Groups

Expectations (prognosis)

Acute pituitary infarction can be life-threatening. The outlook is good for people who have chronic deficiency that is diagnosed and treated.

Complications

Complications of untreated pituitary infarction can include:

If other missing hormones are not replaced, you may develop problems related to hypothyroidism and hypogonadism.

Calling your health care provider

Call your health care provider if you have any symptoms of chronic pituitary insufficiency.

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of acute pituitary infarction, including:

  • Eye weakness
  • Headache
  • Low blood pressure (which can cause fainting)
  • Nausea
  • Vomiting

Be especially concerned if you develop these symptoms and you have already been diagnosed with a pituitary tumor.

Prevention

References

Melmed S, Kleinberg D. Pituitary masses and tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. . 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 9.

Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.