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Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An 11 year old girl with growth hormone deficiency.

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Presentation on theme: "Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An 11 year old girl with growth hormone deficiency."— Presentation transcript:

1 Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An 11 year old girl with growth hormone deficiency

2 Vignette An 11 year old girl presented with growth failure. Serological tests revealed growth hormone (GH) deficiency. Magnetic resonance (MR) imaging of the brain was requested for further evaluation. Grech et al.

3 Imaging Grech et al. Figure 2 Figure 1

4 Ectopic Posterior Pituitary (EPP) EPP results from incomplete caudal extension of the diencephalon during embryogenesis 1. The portal circulation carrying hypothalamic-releasing hormones to the adenohypophysis is disrupted resulting in GH deficiency and more rarely pan- hypopituitarism. EPP is associated with septo-optic dysplasia, with the HESX1 gene being implicated in both conditions 2. MRI demonstrates a 3-8mm T1-hyperintense nodule at the median eminence. The normal posterior pituitary bright spot is absent. The intrinsic T1-hyperintensity relates to lipid-rich neurosecretory granules within the neurohypophysis. Radiologic differential diagnoses include fat containing tumours (lipoma, dermoid, teratoma, and craniopharyngioma) and thrombosed aneurysms. Treatment involves replacing the deficient pituitary hormones. Grech et al.

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