Primary empty sella syndrome and benign intracranial hypertension

1986 ◽  
Vol 61 (3-4) ◽  
pp. 319-325 ◽  
Author(s):  
W. A. E. J. De Vries-Knoppert
Keyword(s):  
Intracranial Hypertension ◽  
Empty Sella ◽  
Benign Intracranial Hypertension ◽  
Empty Sella Syndrome ◽  
Primary Empty Sella

scholarly journals Benign Intracranial Hypertension: A Diagnostic Dilemma

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Gary Y. Shaw ◽  
Stephanie K. Million
Keyword(s):  
Intracranial Hypertension ◽  
Signs And Symptoms ◽  
Pseudotumor Cerebri ◽  
Empty Sella ◽  
Definitive Diagnosis ◽  
Benign Intracranial Hypertension ◽  
Imaging Studies ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Empty Sella Syndrome

Benign intracranial hypertension (BIH) (also known as pseudotumor cerebri and empty sella syndrome) remains a diagnostic challenge to most physicians. The modified Dandy criteria consist of, the classic findings of headache, pulsatile tinnitus, papilledema, and elevated cerebrospinal fluid (CSF) pressure, however, these are rarely collectively present in any one patient. Furthermore, these findings can wax and wane over time. Due to the nature of this disease, both signs and symptoms may be intermittent, making definitive diagnosis difficult. Newer imaging studies, particularly the magnetic resonance venogram (MRV) along with a constellation of correlative findings and associated diseases have given new impetus in the diagnosis, treatment, and pathophysiology of this disease. This has led the authors to offer modifications to the classic Dandy criteria. This report presents three representative cases of BIH highlighting many of the newer advances in both diagnosis and treatment of this perplexing disorder.

Primary empty sella syndrome in a series of 142 patients

2005 ◽  
Vol 103 (5) ◽  
pp. 831-836 ◽  
Author(s):  
Giulio Maira ◽  
Carmelo Anile ◽  
Annunziato Mangiola
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Empty Sella ◽  
Csf Leak ◽  
Csf Shunt ◽  
Csf Dynamics ◽  
Empty Sella Syndrome ◽  
Content Type ◽  
Fine Print ◽  
Primary Empty Sella

Object. The primary empty sella syndrome (ESS) represents a heterogeneous clinical picture characterized by endocrine disturbances and signs of intracranial hypertension. An increase in intracranial pressure (ICP) is proposed to be one of the involved pathogenetic factors. Methods. The series included 142 patients who were observed during a period of 20 years. All patients underwent an ICP and cerebrospinal fluid (CSF) dynamics evaluation through the use of a lumbar constant-rate infusion test. Impairment of ICP and CSF dynamics was observed in 109 patients (76.8%). In 35 of the 36 patients affected by severe intracranial hypertension without rhinorrhea, improvement in adverse neurological symptoms was achieved after implanting a CSF shunt. Visual function, already seriously compromised before surgery, remained severely altered in one patient. In the group of 34 patients affected by rhinorrhea, CSF leakage was controlled using different surgical treatments: CSF shunt placement in 16 cases, surgical repair of the sellar floor in three, and both procedures in the remaining 13. Two patients refused any surgical treatment. Conclusions. The role of increased ICP in the pathogenesis and perpetuation of primary ESS has been confirmed. Adverse neurological signs and a CSF leak are correlated with an actual increase in ICP and are relieved after CSF shunt insertion. Cerebrospinal fluid rhinorrhea is more common than generally thought. Its resolution can be achieved using a careful diagnostic protocol and sometimes may require different surgical procedures.

scholarly journals Primary Empty Sella Syndrome: A Case Report

1970 ◽  
Vol 1 (1) ◽  
pp. 23-25
Author(s):  
Md Sanwar Hossain ◽  
Mahbuba Ashrafi Mumu ◽  
Md Moyenuddin PK
Keyword(s):  
Case Report ◽  
Pituitary Gland ◽  
Subarachnoid Space ◽  
Empty Sella ◽  
Multiple Pregnancies ◽  
Empty Sella Syndrome ◽  
Ocular Abnormalities ◽  
Medical College ◽  
Persistent Headache ◽  
Primary Empty Sella

Primary Empty Sella Syndrome (PES) is a relatively rare or uncommon developmental disease that develops spontaneously. It is characterized by herniation of subarachnoid space within the sella which is often associated with some degree of flattening of pituitary gland. Usually manifested by endocrine abnormalities, ocular abnormalities, rhinitis and intractable persistent headache. It is higher in obese females having multiple pregnancies. Here we report a case of empty sella syndrome in a 27 year old lady to aware the physicians to bear in mind a differential in patients having persistent intractable headache. Key words: Empty Sella Syndrome; Woman; Obesity; Intractable Headache DOI: 10.3329/akmmcj.v1i1.7456 Anwer Khan Modern Medical College Journal 2010; 1(1): 23-25

Clinical features and pituitary function in primary empty sella syndrome

2021 ◽  
Author(s):  
Hadj Kacem Faten ◽  
Asma Zargni ◽  
Dhouha Ben Salah ◽  
Abdellahi Mohamed Ahmed Mohamed ◽  
Fatma Mnif ◽  
...  
Keyword(s):  
Clinical Features ◽  
Empty Sella ◽  
Pituitary Function ◽  
Empty Sella Syndrome ◽  
Primary Empty Sella

Visual disturbances associated with primary empty sella syndrome

1977 ◽  
Vol 44 (3) ◽  
pp. 137-140 ◽  
Author(s):  
E. Xistris ◽  
P. J. Sweeney ◽  
F. A. Gutman
Keyword(s):  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Visual Disturbances ◽  
Primary Empty Sella

Primary empty sella syndrome: the role of visual system herniation

2002 ◽  
Vol 58 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Gerardo Guinto ◽  
Ramiro del Valle ◽  
Elisa Nishimura ◽  
Moises Mercado ◽  
Bárbara Nettel ◽  
...  
Keyword(s):  
Visual System ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Primary Empty Sella

scholarly journals 484 HYPOPITUITARISM IH CHILDREN WITH “PRIMARY EMPTY SELLA SYNDROME (PESS)”

1985 ◽  
Vol 19 (4) ◽  
pp. 191A-191A ◽  
Author(s):  
Nezam Radfar ◽  
Mohammed R Rajj ◽  
Khurshed G Dastur ◽  
Alan L Drash
Keyword(s):  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Primary Empty Sella

Significance of Empty Sella in Cerebrospinal Fluid Leaks

2003 ◽  
Vol 128 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Rodney J. Schlosser ◽  
William E. Bolger
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Sella Turcica ◽  
Radiographic Finding ◽  
Empty Sella ◽  
Senior Author ◽  
Csf Leak ◽  
Benign Intracranial Hypertension ◽  
Cerebrospinal Fluid Leaks ◽  
Csf Leaks

OBJECTIVE: The role of elevated cerebrospinal fluid (CSF) pressures in the pathophysiology of various CSF leaks is not clear. Empty sella syndrome (ESS) is a radiographic finding that can be associated with elevated CSF pressures and may represent a radiographic indicator of intracranial hypertension. We present our experience with CSF leaks of various causes, the prevalence of ESS in the spontaneous and nonspontaneous categories, and the potential pathophysiology and unique management issues of the spontaneous CSF leak group. METHODS: We conducted a retrospective review of medical records, imaging studies, and surgical treatment of CSF leaks in patients treated by the senior author. RESULTS: Sixteen patients with spontaneous CSF leaks and 12 patients with nonspontaneous CSF leaks were surgically treated from 1996 through 2002. In the spontaneous group, 15 patients had complete imaging of the sella turcica. Ten had completely empty sellae and 5 had partially empty sellae, for a total of 100% (15 of 15). In the nonspontaneous group, 9 patients had complete imaging of the sella. Only 11% (1 of 9) had a partially empty sella and that was a congenital leak. Comparison of proportions between these 2 groups was significant ( P = 0.01). The spontaneous group consisted primarily of obese, middle-aged females (13 of 16 patients). CONCLUSION: Empty sella probably represents a sign of elevated intracranial pressure that leads to idiopathic, spontaneous CSF leaks. Spontaneous CSF leaks are strongly associated with the radiographic finding of an empty sella and are more common in obese females, similar to benign intracranial hypertension. This unique population may require more aggressive surgical and medical treatment to prevent recurrent or multiple leaks.

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