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Magnetic resonance imaging(MRI)of the brain in pituitary dwarfs has revealed a previous7sly unknown entity:ectopia of the posterior pituitary (PPE),absence or hypoplasia of the pituitary stalk and hypoplasia of the anterior pituitary.On the basis of this study the traumatic hypothesis could theoretically explain the pathogenesis of PPE only in 32%of the patients with this condition.On the basis of modern understanding of embryogenesis of anterior and posterior pituitary,it is then justified to propose that a defective induction of mediobasal structure of the brain in the early embryo could account for both the complex morphological MRI abnormality and the clinico-endocrinological features encountered in all PPE patients.The close contiguity between the future pituitary and hypothalamus,the peculiar association with congenital midline brain anomalies,and the recent data about a possible role of Pit-1 gene,all support the hypothesis of a congenital defect.Finally,breech delivery can be considered not as a cause of PPE,but as an effect of the embryonic pituitary-hypothalamic abnormalities. |
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anatomy of
dwarfism
growth hormone deficiency
malformation,CNS,congenital
MRI
MRI,abnormal
neuroendocrinology
pituitary
pituitary stalk
pituitary,hyppoplasia
posterior pituitary ectopia
sella turcica,hypoplasia of
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