Salehi Fateme, Kovacs Kalman, Scheithauer Bernd W, Pfeifer Eric A, Cusimano Michael
Department of Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada.
Brain Inj. 2007 Jun;21(6):651-6. doi: 10.1080/02699050701426956.
Approximately 25% of patients with traumatic brain injury (TBI) may develop partial or complete hypopituitarism. The causative mechanisms involved in its development are not clear. To the authors' knowledge, there have been no recent morphologic studies of the pituitary following TBI.
To characterize the resultant histologic changes, this study investigated the pituitaries of 42 patients who died following a motor vehicle accident, all from the Mayo Tissue Registry. Twelve patients died instantly at the scene of the accident (Group I) whereas 30 survived between 3 hours and 7 days (Group II). All pituitary specimens were obtained at autopsy, formalin-fixed and paraffin-embedded. Hematoxylin-eosin sections cut in horizontal or sagittal plane were examined light-microscopically.
No infarction was noted in the pituitary specimens from group I. In group II, 13 of 30 (43%) showed acute infarcts of varying size. The extent of infarction in group II ranged from focal to sub-total necrosis involving 90% of the adenohypophysis.
Underlying adenohypophysial pathology in patients dying after TBI is acute infarction. Loss of large numbers of adenohypophysial cells causes reduced secretion of adenohypophysial hormones and may contribute to post-traumatic hypopituitarism.
约25%的创伤性脑损伤（TBI）患者可能会发生部分或完全性垂体功能减退。其发生的致病机制尚不清楚。据作者所知，近期尚无关于TBI后垂体的形态学研究。
为了描述由此产生的组织学变化，本研究调查了梅奥组织登记处的42例因机动车事故死亡患者的垂体。12例患者在事故现场即刻死亡（I组），而30例患者存活3小时至7天（II组）。所有垂体标本均在尸检时获取，经福尔马林固定和石蜡包埋。对水平或矢状面切片的苏木精-伊红染色切片进行光学显微镜检查。
I组垂体标本未发现梗死。在II组中，30例中有13例（43%）显示出不同大小的急性梗死。II组梗死范围从局灶性到几乎累及腺垂体90%的次全坏死。
TBI后死亡患者腺垂体的潜在病理改变是急性梗死。大量腺垂体细胞的丧失导致腺垂体激素分泌减少，并可能导致创伤后垂体功能减退。
