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An Unusual Case of Reversible Empty Sella
Vincenzo Triggiani1, Vito Angelo Giagulli, Marco Moschetta
1Interdisciplinary Department of Internal Medicine - Endocrinology and Metabolic Diseases, University of Bari "A. Moro", Bari, Italy.
Endocrine, Metabolic & Immune Disorders Drug Targets
|October 2, 2015
Summary
An empty sella, often found incidentally, can be a reversible condition. A case study showed that cerebrospinal fluid (CSF) leak after a lumbar puncture resolved the empty sella and improved symptoms.
Area of Science:
- Neurology
- Radiology
Background:
- Empty sella is a common incidental finding on imaging.
- It results from cerebrospinal fluid (CSF) herniation into the sella turcica, flattening the pituitary gland.
Purpose of the Study:
- To report a rare case of a reversible empty sella.
- To highlight the diagnostic implications of headache in orthostatic position.
Main Methods:
- A patient presented with symptoms including headache and visual impairment, with MRI revealing an empty sella and increased CSF pressure.
- Subsequent MRI showed resolution of the empty sella and signs of CSF hypotension after lumbar puncture.
- Treatment with an epidural blood patch led to gradual improvement.
Main Results:
- The empty sella resolved, and symptoms improved after lumbar puncture and epidural blood patch.
- Cerebrospinal fluid (CSF) hypotension was diagnosed, likely due to a post-lumbar puncture fistula.
- Headache worsening in the orthostatic position was a key indicator of CSF leak.
Conclusions:
- An empty sella can be a reversible condition.
- Lumbar puncture can paradoxically resolve an empty sella by reducing intracranial pressure.
- Suspected CSF leak and intracranial hypotension require prompt diagnosis and management.
