Pituitary Insufficiency with Cerebrovascular Symptoms

THE common association of hypertension and atherosclerosis of vertebral and basilar arteries supplying the brain-stem and cerebellum has been established by clinical and pathological studies.1 , 2 It has been our observation, however, that the development of symptoms in patients with vertebralbasilar insufficiency is often precipitated by a fall in blood pressure from previously higher levels. During the period of hypertension an adequate or marginal cerebral circulation is maintained, but if the blood pressure falls or fluctuates, the perfusion pressure may be periodically insufficient to meet the metabolic requirements of the hindbrain. There are other causes of circulatory failure such as thrombosis . . .