An Unusual Case of Reversible Empty Sella

被引:3
|
作者
Triggiani, Vincenzo [1 ]
Giagulli, Vito Angelo [1 ]
Moschetta, Marco [2 ]
Guastamacchia, Edoardo [1 ]
机构
[1] Univ Bari A Moro, Interdisciplinary Dept Med Endocrinol & Metab Dis, Bari, Italy
[2] Univ Bari A Moro, Sect Diagnost Imaging, Interdisciplinary Dept Med, Bari, Italy
关键词
Cerebrospinal fluid hypotension; empty sella; intracranial hypertension; meningeal leak; IDIOPATHIC INTRACRANIAL HYPERTENSION; CEREBRI;
D O I
10.2174/1871530315666151001141507
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: An empty sella is a relatively common condition, often being an incidental finding at MRI or CT scan. It can develop because of the intrasellar herniation of Cerebro-spinal Fluid (CSF) and arachnoid membrane through an absent or rudimentary diaphragm sellae in concomitance of a sudden and even transient increment of intracranial pressure, leading to a picture in which the pituitary is flattened along the floor of the sella. Case Description: A young female with headache, nausea, dizziness, diplopia and visual impairment showed an empty sella on MRI and increased CSF pressure at the lumbar puncture. After an initial improvement, there was a progressive worsening of the headache, especially in orthostatic position, with transient relief after bed rest and hydration. At MRI the empty sella was no longer evident, cerebellar tonsils were displaced in the occipital foramen and there was an impregnation of the meninges after contrast medium, a picture of CSF hypotension, probably due to the previously performed lumbar puncture causing a fistula with leak of CSF and consequent disappearance of the empty sella. The patient gradually improved after being submitted to epidural blood patch. Conclusions: The case here reported demonstrates that an empty sella can be a reversible condition in rare cases. Its disappearance can be due to the reduction in intracranial pressure caused by the lumbar puncture itself. The changes in the characteristics of the headache, in particular its worsening in the orthostatic position, should lead to the suspicion of CSF leak through a fistula and consequent intracranial hypotension, a dangerous and sometimes life-threatening condition.
引用
收藏
页码:154 / 156
页数:3
相关论文
共 50 条
  • [31] EMPTY SELLA SYNDROME
    GABRIELE, OF
    AMERICAN JOURNAL OF ROENTGENOLOGY RADIUM THERAPY AND NUCLEAR MEDICINE, 1968, 104 (01): : 168 - &
  • [32] EMPTY SELLA HEADACHE
    MORETTI, G
    MANZONI, GC
    MAININI, P
    PASETTI, S
    PARMA, M
    HEADACHE, 1981, 21 (05): : 211 - 217
  • [33] Hyperprolactinaemia and the empty sella
    Thwin, M.
    Brophy, B. P.
    JOURNAL OF CLINICAL NEUROSCIENCE, 2012, 19 (04) : 605 - 606
  • [34] EMPTY SELLA SYNDROME
    SACHDEV, Y
    APPLEBY, A
    EVERED, DC
    HALL, R
    POSTGRADUATE MEDICAL JOURNAL, 1976, 52 (613) : 703 - 705
  • [35] Primary Empty Sella
    Mehla, Sandhya
    Chua, Abigail L.
    Grosberg, Brian
    Evans, Randolph W.
    HEADACHE, 2020, 60 (10): : 2522 - 2525
  • [36] A CASE OF LOW TENSION GLAUCOMA WITH PRIMARY EMPTY SELLA
    YAMABAYASHI, S
    YAMAMOTO, T
    SASAKI, T
    TSUKAHARA, S
    BRITISH JOURNAL OF OPHTHALMOLOGY, 1988, 72 (11) : 852 - 855
  • [37] Empty sella syndrome
    Sushil Kumar Jaiswal
    Indian Journal of Otolaryngology and Head and Neck Surgery, 1999, 52 (1): : 91 - 93
  • [38] EMPTY SELLA SYNDROME
    RAPP, T
    KO, JP
    DUNKER, RO
    ULLRICH, IH
    WEST VIRGINIA MEDICAL JOURNAL, 1978, 74 (07) : 159 - 164
  • [39] Empty sella turcica
    Michelozzi, G
    Calabrò, F
    Schiavoni, S
    Bolelli, T
    Capellini, C
    RIVISTA DI NEURORADIOLOGIA, 2000, 13 (03): : 353 - 366
  • [40] THE EMPTY SELLA SYNDROME
    HUPP, JR
    GWINUP, G
    JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 1983, 41 (07) : 463 - 467