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The empty sella syndrome analysis of 10 cases
Acta Neurochirurgica
|January 1, 1977
Summary
This study presents ten cases of empty sella syndrome, highlighting its association with pituitary adenomas, pregnancy, congenital malformations, and cerebrospinal fluid fistulas. Diagnostic imaging and surgical repair with dural grafting were effective treatments.
Area of Science:
- Neurosurgery
- Endocrinology
- Radiology
Background:
- Empty sella syndrome (ESS) is a condition where the pituitary gland appears shrunken within the sella turcica.
- ESS can be primary or secondary to other conditions, including pituitary adenomas and increased intracranial pressure.
Observation:
- Ten ESS cases were analyzed, with associations to treated pituitary adenomas (4), pregnancy (3), congenital malformations (2), and pseudotumor cerebri (5).
- Cerebrospinal fluid (CSF) fistulas were present in the remaining cases, with varied etiologies including spontaneous and post-traumatic origins.
- Occult CSF fistulas were identified as a cause of recurrent meningitis.
Findings:
- Gamma cisternography and iodocisternography were effective diagnostic tools for both ESS and CSF fistulas.
- Surgical intervention in nine cases revealed intrasellar cysts (4) or deficient diaphragmatic sellae (5).
- Surgical treatment involved dural grafting using lyophilized dura and biological glue to repair the sellar floor.
Implications:
- Early and accurate diagnosis of ESS and associated CSF fistulas is crucial for effective management.
- Surgical repair of the sellar floor defect can successfully treat ESS with CSF fistulas.
- Understanding the diverse presentations of ESS aids in clinical diagnosis and treatment planning.