Hypothalamus – releases TRH, CRH, GnRH, GHRH, and dopamine into median eminence; passes through neurohypophysis on way to adenohypophysis
Dopamine – inhibits prolactin secretion
Posterior pituitary (neurohypophysis)
• ADH – supraoptic nuclei, regulated by osmolar receptors in hypothalamus
• Oxytocin – paraventricular nuclei in hypothalamus
• Neurohypophysis does not contain cell bodies
Anterior pituitary (80% of gland, adenohypophysis)
• Releases ACTH, TSH, GH, LH, FSH, and prolactin
• Does not have its own direct blood supply; passes through neurohypophysis 1st (portal venous system)
Bi-temporal hemianopia – pituitary mass compressing optic nerve (CN II) at chiasm
Nonfunctional tumors – almost always macroadenomas; present with mass effect and decreased ACTH, TSH, GH, LH, FSH. Tx: transsphenoidal resection
Contraindications to transsphenoidal approaches – suprasellar extension, massive lateral extension, dumbbell-shaped tumor
Most pituitary tumors respond to bromocriptine (dopamine agonist)
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