ABSTRACT
The anterior pituitary secretes thyroid-stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), growth hormone (GH), prolactin (PRL) and the gonadotrophins follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Their secretion is subject to marked clinical rhythms and varies widely between the different hormones. The anterior portion of the pituitary may be divided into three constituent parts, such as, pars anterior, pars intermedia, and pars tuberalis. The posterior pituitary sits in continuity with the hypothalamus and secretes oxytocin and antidiuretic hormone. These are released from the axons of supraoptic and paraventricular neurons that run through the pituitary stalk from the hypothalamus. Pituitary apoplexy should be considered in all patients presenting with a sudden-onset headache, vomiting, visual impairment, meningism and reduced consciousness. The first priority in managing a patient with pituitary apoplexy is to ensure haemodynamic stability. Empirical steroid therapy is used in patients who are haemodynamically unstable, demonstrate reduced visual acuity or who have a reduced consciousness level.
