Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

EditorialEDITORIAL

Etiology of Congenital Growth Hormone Deficiency

Walter Kucharczyk
American Journal of Neuroradiology June 2000, 21 (6) 1000;
Walter Kucharczyk
M.D., F.R.C.P
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Growth hormone deficiency (GHD) comprises a spectrum of diseases. The disorder may consist of an isolated deficiency of GH, or it may be part of a syndrome of multiple pituitary hormone deficiencies (MPHD). Morphologic changes in the pituitary gland and stalk have been observed in a large percentage of these cases on MR images. Since the late 1980s, when these morphologic changes were first reported, there have been a large number of reports describing this disease in both the radiology and endocrinology literature. Some of these reports had large cohorts with series of over 100 patients. In the numerous publications that now exist on this topic, two hypotheses have been proposed about the etiology of this disease: perinatal head trauma and dysgenesis.

The earliest reports on the MR imaging findings in children with GHD documented a striking association between adverse perinatal events and breech delivery, leading to the hypothesis that birth or perinatal trauma might be the cause of the pituitary stalk transection that is observed so frequently in this disease. In 1990, Maghnie et al reported 37 cases of MPHD and GHD (1). Adverse perinatal events were present in 80% of those cases in which morphologic lesions were observable on MR images, but the incidence of perinatal events was much lower in those with normal-appearing MR images or isolated GHD. The authors speculated that the disease was a congenital syndrome worsened by breech delivery.

In the middle 1990s, reports appeared documenting an association of GHD and MPHD with midline anomalies of the brain, including lesions of the corpus callosum, septum pellucidum, and optic chiasm and nerves (2–4). A familial association also became recognized. Authors began to favor more strongly a genetic etiology for this disorder.

Triulzi et al published an important study with a series of 101 patients in 1994 (2). Only 32% of the patients in this series had a breech delivery. He concluded that the disease in the other 68% had to have a different cause. He also reported that 12% of the patients in his series had anomalies of the brain. He concluded that dysgenesis was the probable etiology of GHD and MPHD in the majority of cases, and he implied that breech presentation was the result of a fetal endocrinopathy, rather than breech presentation (with perinatal head trauma) being the cause of the endocrinopathy. Many subsequent papers, including the paper by Maintz et al in this issue of the AJNR (page 1116), have documented further familial occurrences of this disorder, lending more weight to the hypothesis that dysgenesis is the etiology of many, or even most, cases of GHD.

It seems reasonable to conclude that GHD and MPHD are genetically determined diseases in most cases, and that breech delivery has the potential to worsen the severity of the pituitary endocrinopathy. Although breech presentation is strongly associated with fetal hypopituitarism, breech presentation probably causes very few cases. That does not indicate that dysgenesis is the only cause of GHD and MPHD. It is well recognized that blunt head trauma can transect the stalk, and cases of stalk transection can result in GHD in children (4).

References

  1. ↵
    Maghnie M, Larizza D, Triulzi F, Sampaolo P, Scotti G, Severi F. Hypopituitarism and stalk agenesis: a congenital syndrome worsened by breech delivery? Horm Res 1991;35:104-108
    PubMed
  2. ↵
    Triulzi F, Scotti G, di Natale B, et al. Evidence of a congenital midline brain anomaly in pituitary dwarfs: a magnetic resonance imaging study in 101 patients. Pediatrics 1994;93:409-416
    Abstract/FREE Full Text
  3. Hellstrom A, Wiklund LM, Svensson E, Stromland K, Albertsson-Wikland K. Midline brain lesions in children with hormone insufficiency indicate early prenatal damage. Acta Paediatr 1998;87:528-536
    CrossRefPubMed
  4. ↵
    Yamanaka C, Momoi T, Fujisawa I, et al. Acquired growth hormone deficiency due to pituitary stalk transection after head trauma in childhood. Eur J Pediatr 1993;152:99-101
    CrossRefPubMed
  • Copyright © American Society of Neuroradiology
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology
Vol. 21, Issue 6
1 Jun 2000
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Etiology of Congenital Growth Hormone Deficiency
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
Walter Kucharczyk
Etiology of Congenital Growth Hormone Deficiency
American Journal of Neuroradiology Jun 2000, 21 (6) 1000;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
Etiology of Congenital Growth Hormone Deficiency
Walter Kucharczyk
American Journal of Neuroradiology Jun 2000, 21 (6) 1000;
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Supporting Imaging Research: A Framework for Equity and Excellence in Neuroradiology
  • Neuroimaging within the Stroke Treatment Paradigm – An Update from the Brain Attack Coalition
  • Advancing Neuroradiology through Innovation and Member Engagement
Show more Editorial

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire