Pituitary gland Rathke's pouch. This contrasts with the posterior pituitary, which originates from neuroectoderm. Endocrine cells of the anterior pituitary are controlled by regulatory hormones released by parvocellular neurosecretory cells in the hypothalamic capillaries leading to infundibular blood vessels, which in turn lead to a second capillary bed in the anterior pituitary. This vascular relationship constitutes the hypothalamo-hypophyseal portal system. Diffusing out of the second capillary bed, the hypothalamic releasing hormones then bind to anterior pituitary endocrine cells, upregulating or downregulating their release of hormones. The anterior lobe of the pituitary can be divided into the pars tuberalis (pars glandularis) and pars
Pituitary apoplexy replacement; in this case, blood levels of cortisol are determined at 9:00 AM (as cortisol levels vary over the day). A level below 550 nmol/l indicates a need for replacement. The decision on whether to surgically decompress the pituitary gland is complex and mainly dependent on the severity of visual loss and visual field defects. If visual acuity is severely reduced, there are large or worsening visual field defects, or the level of consciousness falls consistently, professional guidelines recommend that surgery is performed. Most commonly, operations on the pituitary gland are performed through transsphenoidal surgery. In this procedure, surgical instruments