Published: 2020-11-24

Pituitary stalk transection syndrome

Gayathri Sajeevan, Sajitha Nair, Devika Geetha, Nisha Bhavani, C. Jayakumar, Suchitra Sivadas


Growth hormone deficiency is one of the most common endocrinological causes for short stature. It can either be idiopathic or associated with organic causes like tumors or following surgery. One of the rare causes for growth hormone deficiency in children is pituitary stalk transection syndrome. It can be diagnosed by magnetic resonance imaging of the hypothalamus and pituitary gland which shows an ectopic or absent posterior pituitary, an absent or interrupted pituitary stalk, or small anterior pituitary in combination with growth hormone or other pituitary hormone deficiencies. Current report presents a child with pituitary stalk transection syndrome who was brought for evaluation of hypoglycemic seizures.


Growth hormone deficiency, PSTS, Short stature

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El Chehadeh-Djebbar S, Callier P, Masurel-Paulet A, Bensignor C, Méjean N, Payet M, et al. 17q21.31 microdeletion in a patient with pituitary stalk interruption syndrome. Eur J Med Genet. 2011;54(3):369-73.

Fujisawa I, Kikuchi K, Nishimura K, Togashi K, Itoh K, Noma S, et al. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging. Radiology. 1987;165(2):487-9.

Simmons GE, Suchnicki JE, Rak KM, Damiano TR. MR imaging of the pituitary stalk: size, shape, and enhancement pattern. Am J Roentgenol. 1992;159: 375-7.

Tauber M, Chevrel J, Diene G, Moulin P, Jouret B, Oliver I, et al. Long-term evolution of endocrine disorders and effect of GH therapy in 35 patients with pituitary stalk interruption syndrome. Horm Res. 2005;64(6):266-73.

Guo Q, Yang Y, Mu Y, Lu J, Pan C, Dou J, et al. Pituitary stalk interruption syndrome in Chinese people: clinical characteristic analysis of 55 cases. PLoS One. 2013;8:e53579.

Pinto G, Netchine I, Sobrier ML, Brunelle F, Souberbielle JC, Brauner R. Pituitary stalk interruption syndrome: A clinical-biological-genetic assessment of its pathogenesis. J Clin Endocrinol Metab. 1997;82:3450-4.

Patkar D, Patankar T, Krishnan A, Prasad S, Shah J, Limdi J. MR imaging in children with ectopic pituitary gland and anterior hypopituitarism. J Postgrad Med. 1999;45(3):81-3.

Melo ME, Marui S, Carvalho LR, Arnhold IJ, Leite CC, Mendonça BB, et al. Hormonal, pituitary magnetic resonance, LHX4 and HESX1 evaluation in patients with hypopituitarism and ectopic posterior pituitary lobe. Clin Endocrinol. 2007;66:95-102.

Simon D, Hadjiathanasiou C, Garel C, Czernichow P, Léger J. Phenotypic variability in children with growth hormone deficiency associated with posterior pituitary ectopia. Clin Endocrinol. 2006;64:416-22.

Vijayanand P, Mahadevan S, Shivbalan S, Reddy N, Ramdoss N. Pituitary stalk interruption syndrome (PSIS). Indian J Pediatr. 2007;74:874-5.

Reynaud R, Albarel F, Saveanu A, Kaffel N, Castinetti F, Lecomte P, et al. Pituitary stalk interruption syndrome in 83 patients: novel HESX1 mutation and severe hormonal prognosis in malformative forms. Eur J Endocrinol. 2011;164(4):457-65.

Chen S, Léger J, Garel C, Hassan M, Czernichow P. Growth hormone deficiency with ectopic neurohypophysis: Anatomical variations and relationship between the visibility of the pituitary stalk asserted by magnetic resonance imaging and anterior pituitary function. J Clin Endocrinol Metab. 1999;84:2408-13.