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Article
December 1940

PRIMARY PITUITARY ADENOMA AND THE SYNDROME OF THE CAVERNOUS SINUS: A CLINICAL AND ANATOMIC STUDY

Author Affiliations

PHILADELPHIA
From the Neurosurgical Service of the Hospital of the University of Pennsylvania.
Charles Harrison Frazier Fellow in Neurologic Surgery, Hospital of the University of Pennsylvania.

Arch Ophthalmol. 1940;24(6):1197-1236. doi:10.1001/archopht.1940.00870060139010
Abstract

Through the brilliant labors of Cushing, Frazier and de Schweinitz, the signs and symptoms establishing the diagnostic criteria for primary pituitary adenoma have become familiar to every student. Of the classic triad of signs, the chiasmal syndrome, constitutional dyspituitarism and roentgen evidence of hypophysial disease, the first mentioned has played the largest role in the recognition of pituitary adenoma. Indeed, the preeminence of the visual component in the semiology of pituitary adenoma led Henderson,1 who recently published a critical review of Cushing's series of 338 cases, to declare : "It is exceptional for a chromophobe adenoma to be diagnosed or even suspected before it is sufficiently large to implicate the visual pathways. . . . operation would hardly be justified before vision is affected." This remark may be taken as the general opinion expressed by the many who have written on the diagnosis of pituitary adenoma.

Though the nerves which supply the ocular

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