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IRRADIATION of the brain has been carried out for many years as a therapeutic measure in patients with neoplasms. It was Fischer and Holfelder in 1930 who first described a case of delayed radiation necrosis of the brain in man. This occurred seven years after the irradiation of a rodent ulcer. Markiewicz (1935) and Scholz and Hsll (1938) described delayed necrosis occurring eighteen months after the last exposure of the brain to irradiation. In the former paper it was for the treatment of a skin disease. A full description of the pathological findings in delayed radiation necrosis of the brain in man was given by Pennybacker and Russell (1948). Almost all the publications to date are concerned with changes following the experimental irradiation of animals or the irradiation of gliomas or skin tumours in man. This paper, however, is concerned with delayed necrosis of the brain in man following the irradiation of pituitary tumours. This complication of X-ray therapy to the pituitary does not appear to have been fully described before. Irradiation of pituitary adenomata is a therapeutic method of a long history and acknowledged value. It was practised by Cushing in the earlier part of the century and Henderson (1939), in a review of Cushing's series of cases, found that post-operative X-radiation increased the number of patients surviving five years without recurrence. Harvey Jackson (1958) stated that, in his experience, cases receiving post-operative X-ray therapy have a more lasting recovery than those receiving surgery alone. It is only recently in the literature, however, that the danger of delayed necrosis following therapeutic irradiation of pituitary tumours, has been recognized. Jackson Richmond, in 1958, briefly mentioned the first case that is described in this paper. In such cases deterioration due to delayed radiation necrosis of the brain may not be easily recognized either clinically or at autopsy, and the probability that by guest on Septe