On the Origins of Pituitary Apoplexy

This paper sketches the early history of pituitary apoplexy, a disorder later fully described in 1950 by Brougham, Heusner and Adams. Haemorrhage or necrosis in an adenoma causes a characteristic sudden drowsiness, stupor or coma, headache and stiff neck, ocular palsy, and impaired acuity with visual field loss owing to optic nerve or chiasmal compression. The associated endocrinopathy and management are described. © 2015 S. Karger AG, Basel Between 1912 and 1938, Harvey Cushing (1869–1939) [1] published 5 books about his unrivalled study and treatment of 2023 brain tumours. Approximately 70 years before his seminal monograph, The functions of the pituitary body [2] , and his account of its surgery ( fig. 1 and 2 ) [3] , the German embryologist Martin Heinrich Rathke (1793–1860) gave one of the earliest descriptions of the pituitary gland [4] . He described the embryonic structure, known as Rathke’s pouch, from which the anterior lobe of the pituitary gland develops. But its functions and histological pathology were not known until basophilic, eosinophilic and chromophobe adenomas were demarcated in the late 19th century [5–7] . Received: March 12, 2015 Accepted: May 3, 2015 Published online: June 23, 2015 John M.S. Pearce, MD, FRCP 304 Beverley Road Anlaby East Yorks, HU10 7BG (UK) E-Mail jms.pearce @ me.com © 2015 S. Karger AG, Basel 0014–3022/15/0742–0018$39.50/0