Hypophyseal artery

Arterial blood reaches the pituitary gland via the superior hypophyseal artery, a branch of the internal carotid artery. Venous blood is supplied through a venous portal system that originates in the median eminence of the hypothalamus and ends in sinusoidal capillaries of the pituitary gland. This venous system is known as the hypothalamic-hypophyseal portal system. This system carries neurosecretory hormones from the hypothalamus to the adenohypophysis. These hypothalamic factors stimulate or inhibit the release of hormones from the adenohypophysis. Retrograde flow from the adenohypophysis to the median eminence of the hypothalamus is also believed to occur. With upstream flow, pituitary hormones can reach the hypothalamus and influence hypothalamic function through a short feedback loop. 

Other ICA branches arising from the C5 segments are the posteroinferior hypophyseal artery, the lateral artery of the clivus and the recurrent artery of the foramen lacerum. These are constant vessels that are anastomosed with the external carotid system through the ascending pharyngeal artery and in some cases with middle meningeal artery branches. 

The adenohypophysis does not have a direct anatomical connection with the hypothalamus therefore, regulation of hormone secretion by way of neuronal signals is not possible. Instead, these two structures are associated by a specialized circulatory system and the secretion of hormones from the adenohypophysis is regulated by hormonal signals from the hypothalamus (see Figure 10.2). Systemic arterial blood is directed first to the hypothalamus. The exchange of materials between the blood and the interstitial fluid of the hypothalamus takes place at the primary capillary plexus. The blood then flows to the adenohypophysis through the hypothalamic-hypophyseal portal veins. Portal veins are blood vessels that connect two capillary beds. The second capillary bed in this system is the secondary capillary plexus located in the adenohypophysis. 

Small hypophyseal and meningeal branches of the ICA are not visible in MR angiographies. The first originating vessel is the ophthalmic artery from the C3 segment. Distally the posterior communicating artery and subsequently the anterior choroidal artery arise from the ICA. A direct origin of the posterior cerebral artery from the ICA is referred to as embryonic type. 

The hypothalamus is a small region of the brain in the ventral aspect of the diencephalon. In the adult human, it is about 2.5 cm in length and weighs about 4 g. Ventromedi-ally, it surrounds the third ventricle and is continuous with the infundibular stalk of the pituitary (hypophysis). This cone-shaped region of the hypothalamus, the median eminence, consists mainly of axonal fibers from hypothalamic neurons, which either terminate in the median eminence or continue down into the posterior lobe of the pituitary, and it is perfused by a capillary network (primary plexus) derived from the carotid arteries. Blood from the primary plexus is transported by portal vessels (hypophyseal portal vessels) to another capillary network (secondary plexus) in the anterior lobe of the pituitary (adenohypophysis) (Figure 31-1). 

From this description of the hypophyseal vasculature, it is obvious that the anterior lobe receives no direct arterial blood but receives all its blood through the hypophyseal venous system. 

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