Pituitary stalk
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View Frank Gaillard's current disclosures- Infundibulum (pituitary)
- Infundibular stalk
The pituitary stalk, also known as the infundibulum or infundibular stalk, is a funnel-shaped projection from the hypothalamus containing unmyelinated axons from the supraoptic and periventricular nuclei 3,4. These terminate within the posterior pituitary.
Superiorly, the infundibulum surrounds the infundibular recess of the third ventricle.
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Embryology
The infundibulum forms as the downward extension of the hypothalamus at the same time as the anterior pituitary is being formed by the upward migration of Rathke's pouch (see pituitary gland).
In addition to unmyelinated axons of the magnocellular neurones arising from the supraoptic and periventricular nuclei, the infundibulum also includes pituicyte and tanycyte, specialised modified glial cells, and capillary beds of the venous portal circulation 3,4.
Radiographic features
Before contrast, the infundibulum is of somewhat lower T1 signal than the adjacent optic chiasm and of the posterior pituitary (which has intrinsic high T1 signal; (posterior pituitary bright spot) 4.
As the infundibulum is outside the blood-brain barrier (like the rest of the pituitary gland) it enhances following the administration of gadolinium 4.
There have been some studies looking at the range of normal sizes of the pituitary stalk. One study had a normal range of 2:
3.25 mm +/- 0.56 (SD) at the level of the optic chiasm
1.91 mm +/- 0.40 (SD) as the stalk enters the pituitary gland proper
In other words, 95% of patients should have a stalk that measures no more than:
4.4 mm at the level of the optic chiasm, and
2.7 mm just above the gland
Related pathology
differential diagnosis of pituitary stalk abnormal enhancement
References
- 1. Laurie A. Loevner. Brain Imaging. (2009) ISBN: 9780323031790 - Google Books
- 2. Simmons G, Suchnicki J, Rak K, Damiano T. MR Imaging of the Pituitary Stalk: Size, Shape, and Enhancement Pattern. AJR Am J Roentgenol. 1992;159(2):375-7. doi:10.2214/ajr.159.2.1632360 - Pubmed
- 3. Ian S. Scott, Arpita Chattopadhyay, Olaf Ansorge. Development and Microscopic Anatomy of the Pituitary Gland. MDTextcom, Inc. 2024. https://www.ncbi.nlm.nih.gov/books/NBK425703/ - Pubmed
- 4. Hamilton B, Salzman K, Osborn A. Anatomic and Pathologic Spectrum of Pituitary Infundibulum Lesions. AJR Am J Roentgenol. 2007;188(3):W223-32. doi:10.2214/ajr.05.2027 - Pubmed
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