Final Project for Neurobiology of Everyday Life Final Project - Coursera

1. The Neurobiology of Everyday
Life
Understanding the
Brain
Sanyukta S Jalihalkar

2. OVERVIEW
Pituitary adenomas are tumors of the anterior pituitary.
The majority of pituitary tumours are slow-growing and
benign (non-cancerous).
They are categorised according to their size or cell of
origin.
 Microadenoma (< 10mm)
 Macroadenoma (> 10mm)
 Gigantic tumours (> 40mm)

3.  The presentation of pituitary adenoma depends on
tumor size and functional status.
 Pituitary microadenoma is frequently discovered by
chance during an MRI head scan. Unless the
tumour is hormonally active, patients have no
symptoms.
 Pituitary macroadenoma presents with mass effects
and potentially hormonal deficiency or hormonal
excess.

4. PRESENTATION
Pituitary adenomas presents clinically in three
ways: hormone hypersecretion or deficiency
syndromes, neurologic signs from an increasing
gland's mass effect, or an incidental finding on
imaging.
Pituitary adenomas are best diagnosed by imaging
studies and hormonal testing.

5.  HORMONAL
 A pituitary adenoma may present as a distinct syndrome
of hormone hypersecretion or partial/complete
hypopituitarism, most often hypogonadism.
 This is a result of interference with normal hormone
secretion, either from direct compression of the pituitary
gland or inhibition of the pulsatile secretion of LH,
leading to inadequate gonadal stimulation.

7.  NEUROLOGIC
 The most common neurologic symptoms in patients
with pituitary adenomas are headaches and visual
changes.
 Neurologic symptoms are more common in
nonfunctioning adenomas or gonadotroph adenomas
because these tumors do not secrete sufficient
hormones to cause endocrine-type symptoms, and
their diagnosis often is delayed until patients present
with symptoms of mass effect like, Visual impairment,
Headache, Hormonal deficiency.

8. INCIDENTAL
 Increased use and sensitivity of computed tomography
(CT) and magnetic resonance imaging (MRI) have
identified many pituitary lesions that otherwise might
not have been detected.
 Autopsy and radiology studies suggest that between
10% and 20% of all pituitary adenomas may be
unsuspected or found incidentally.

9. DIAGNOSIS
 The technique to diagnosing a suspected pituitary
adenoma is determined by the symptoms.
 A functional adenoma is probable in a patient who
exhibits symptoms of hormone excess. As a first
series of laboratory tests, consensus guidelines
recommend getting an endocrine panel that
include serum prolactin, insulinlike growth factor 1
(IGF-1), LH/FSH, TSH, thyroxine (T4), and an
initial test for cortisol excess—a 24-hour urine
free cortisol, a late night salivary cortisol, or a low-
dose dexamethasone suppression test.

10.  If a pituitary mass is suspected, the recommended first
imaging investigation is an MRI. If a patient has visual
problems or imaging shows that the optic nerve is
impacted, the patient should be referred for formal visual
field tests and an ophthalmologic examination.
 When a pituitary mass is found by chance, diagnostic
tests should be performed to determine whether the
mass is functioning or not. Even if the patient is
asymptomatic, the Endocrine Society's clinical practise
guidelines for pituitary incidentalomas advocate a
thorough evaluation of pituitary function.

11. TREATMENT
 Treatments for pituitary
adenoma have three basic
therapeutic goals:
minimising hormone
hypersecretion and
associated clinical
manifestations, reducing
tumour size to relieve mass
effect symptoms, and
addressing hormone
shortages.

12. The ways in which this course has allowed me to
better analyze the events and phenomena aroundme
 This course has opened doors to opportunities in
the field of neurology for me as a pharmacy
student. It has given me a better and more in-
depth understanding of how the brain influences
us in our daily lives through regulating emotions
and behaviour, which are the most important
aspects of our ability to live and communicate.
The course has helped me expand my
knowledge, which will help me succeed in my
master's degree.

13. REFRENCES
 Russ S, Anastasopoulou C, Shafiq I. Pituitary
Adenoma. [Updated 2021 Jul 18]. In: StatPearls
[Internet]. Treasure Island (FL): StatPearls
Publishing; 2021 Jan.
 Lake MG, Krook LS, Cruz SV. Pituitary
adenomas: an overview. Am Fam Physician.
2013 Sep 1;88(5):319-27. PMID: 24010395.