Postpartum Necrosis of the Anterior Lobe of the Pituitary Gland

COOK, JULIUS E.

doi:10.1001/archinte.1951.03810040042002

Cited by 20 publications

(8 citation statements)

References 21 publications

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“…Acute ischemic necrosis of the pituitary associated with blood loss during delivery was described first by Sheehan in 1937 1 ) , following considerable research and a number of reports 7 – 9 ) . However, it is regarded as a rare complication in modern obstetrics.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomographic Correlation with Pituitary Function in Sheehan`s Syndrome

Lee

Ahn

et al. 1992

Korean J Intern Med

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Twenty six patients with Sheehan’s syndrome were studied with high-resolution computed tomography (CT) and the sequential pituitary stimulation test in order to correlate the CT findings of the sella turcica with the pituitary reserve functions. CT revealed 21 completely empty sella (CES), 4 partially empty sella (PES) and 1 normal sella. Panhypopituitarism occurred in 1 of 4 patients with PES and 20 of 21 with CES. One patient showing normal sella had a normal preservation of prolactin (PRL), thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) and lutenizing hormone (LH). In all patients with PES and CES, growth hormone (GH) responses to hypoglycemia and PRL responses to thyrotropin releasing hormone (TRH) were blunted. Three (75.0%) with PES had normal basal cortisol levels, which were more frequent than two (9.6%) with CES; however, most of the PES (3 of 4) and CES (20 of 21) demonstrated blunted cortisol responses to hypoglycemia. Three (75.0%) with PES and only one (4.8%) with CES had normal thyroxine levels and TSH responses to TRH. None with PES showed decreased basal and stimulated levels of FSH and LH, whereas 15 of 21 with CES did. The pituitary functions of the patients having considerable amounts of pituitary remnants visualized by CT were relatively preserved for TSH, cortisol, FSH and LH. Considering the above results, changes in the amounts of pituitary remnants detected by CT might correlate with hormonal secretory capacity.

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Section: Discussionmentioning

confidence: 99%

Computed Tomographic Correlation with Pituitary Function in Sheehan`s Syndrome

Lee

Ahn

et al. 1992

Korean J Intern Med

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“…It is possible that these disturbances may have resulted from too high a dosage. Cook et al (1951) say that one of their patients is doing well on 25 mg. of cortisone daily, given either by tablet or parenterally. Nevertheless there is no doubt that cQrtisone is the most efficient method of producing clinical improvement in hypopituitarism that has been found up to the present.…”

Section: Mental and Physical Changesmentioning

confidence: 99%

Cortisone and A.C.T.H. in Hypopituitarism

Summers¹,

Sheehan²

1951

BMJ

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“…Acute ischemic necrosis of the pituitary associated with blood loss during delivery was first described by Sheehan in 1937 [1][2][3], followed by considerable investigation and a number of reports [13][14][15]. 55 now is considered very rare among obstetric complications.…”

Section: Discussionmentioning

confidence: 99%

“…55 now is considered very rare among obstetric complications. Failure of lactation is an early indication that pituitary function has been compromised, but the additional clinical features of myxedema and adrenal insufficiency appear much later, occasionally resulting in death [2,13]. Sheehan found the actual tissue injury to occur within the first few hours of postpartum hemorrhage with progression to loss of pituitary volume occurring more gradually [3].…”

Section: Discussionmentioning

confidence: 99%