Review: Neurology and medicine
Neurology of the pituitary gland
J R Andersona, N Antounb, N Burnetc, K Chatterjeed, O Edwardse, J D Pickardf, N Sarkiesg
a Department of
Neuropathology, Box 235, b Department of Neuroradiology, Box 219, c Department of Neuro-oncology, Box 193, d Department
of Diabetes and Endocrinology Box 157, e Department of Diabetes and Endocrinology, Box 49, f Department of Neurosurgery,
Box 167, g Department of
Ophthalmology, Box 41, Addenbrooke's Hospital, Cambridge, UK
Correspondence to: Professor JD Pickard, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. Telephone 0044 1223 336946.
Received 2 November
1998 and in revised form 27 January 1999;
Accepted 4
February 1999
| The first 150 words of the full text of this article appear below. |
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Introduction |
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This
review will focus on those aspects of pituitary disease immediately
relevant to neurologists and neurosurgeons when assessing and
counselling patients. It is essential to adopt a multidisciplinary approach to the diagnosis and management of pituitary disease as
emphasised by the recently published guidelines from the Royal College
of Physicians of London.1-4
| Table Removed (Available Only in the Full Text) |
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Range of pathology presenting in the sellar region |
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The commonest lesions presenting in this region are pituitary tumours (incidence of 15-20/million/year), including adenomas and craniopharyngiomas, aneurysms, and meningiomas, but many other diseases need to be considered (table 1).
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Neurological presentations of pituitary disease |
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"Pituitary incidentalomas" may be disclosed when investigating
unrelated disease (fig 1). Although figures from 5% to 27% have been
quoted for the incidence of subclinical adenomas at postmortem, far
fewer are of significant size
that is, over 5 mm in diameter with
deviation of the stalk and unilateral enlargement of the gland. Careful
endocrine and visual assessments are required and, where no
abnormalities are found, most can
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