Análisis de la probabilidad conjunta y a posteriori entre aracnoidocele selar primario, sus comorbilidades y enfermedad audiovestibular

Background.The study of hormonal status in patients with erectile dysfunction (ED), especially the older and senior age groups, is most often limited to the evaluation of testosterone fractions Aim:demonstrate the effectiveness of transcranial magnetotherapy in a combined treatment regimen for patients with empty sella syndrome (ESS). Methods.Results of diagnostics examination and treatment of 118 patients with the ED hormonal form at the age of 2357 are studied. The expressiveness of disturbances of erectile function and signs of androgenic deficiency are estimated by means of questionnaires of AMS and a scale of Morley, the penil color flow Doppler ultrasound with intracavernous pharmacological tests is carried out, the hormonal status is estimated. At suspicion of neuroendocrine pathology MRI of the brain is executed. At all examined patients signs of decrease erectile functions are revealed. In 62 (52.5%) observations during MRI the picture of ESS is revealed. In 22 (18.6%) observations the changes of an eyeground demonstrating increase in intracranial pressure takes place, however loss of fields of vision is not observed in any of patient. Persistent headaches are noted in 19 (16.1%) observations. In 46 (39%) observations at patients with considerable obesity signs of disturbance of tolerance to glucose and insulin resistance are revealed. To patients hormone replacement therapy is appointed, at identification of a hyperprolactinemia agonists of dopamine receptors in an individual dosage under control of level of prolactin are used, therapy of intracranial hypertensia is carried out. In complex therapy transcranial magnetotherapy is used. Results.Therapy is effective, during treatment increase in frequency and duration of sexual intercourses is noted. At control Doppler researches of a penis improvement of a regional hemodynamics is noted. Cancellation of medicines lead to resuming of symptomatology of a disease. Conclusion.Thus, the research shows powerful value of a syndrome of ESS in a pathogeny of ED demanding multidisciplinary approach with involvement of adjacent specialists endocrinologists, neurologists and ophthalmologists. It is important to note that ESS, in most cases, is an accidental tomographic finding, at the same time often is followed by disturbance of tolerance to glucose, obesity, a metabolic syndrome. Introduction in complex therapy of transcranial magnetic influence substantially improves results of treatment of this category of patients, as due to additional stimulation of synthesis of pituitary hormones, and cerebral decompression.

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Diagnostics and the combined medical tactics at patients with erectile dysfunction at a empty sella syndrome

Markosyan

Гришаи²,

Bolevich

et al. 2020

Russ. J. of Physui., Balneo. and Rehab.

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The Link Between Empty Sella Syndrome, Fibromyalgia, and Chronic Fatigue Syndrome: The Role of Increased Cerebrospinal Fluid Pressure

Hulens

Dankaerts

Rasschaert³

et al. 2023

JPR

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The etiopathogenesis of fibromyalgia (FM) and chronic fatigue syndrome (CFS) is not yet elucidated. Hypothalamo-pituitary-adrenal (HPA) axis dysfunction is reflected in the hormonal disturbances found in FM and CFS. Some study groups have introduced a novel hypothesis that moderate or intermittent intracranial hypertension may be involved in the etiopathogenesis of FM and CFS. In these conditions, hormonal disturbances may be caused by the mechanical effect of increased cerebrospinal fluid pressure, which hampers blood flow in the pituitary gland. Severe intracranial pressure may compress the pituitary gland, resulting in primary empty sella (ES), potentially leading to pituitary hormone deficiencies. The aim of this narrative review was to explore whether similar hormonal changes and symptoms exist between primary ES and FM or CFS and to link them to cerebrospinal fluid pressure dysregulation. A thorough search of the PubMed and Web of Science databases and the reference lists of the included studies revealed that several clinical characteristics were more prevalent in primary ES, FM or CFS patients than in controls, including increased cerebrospinal fluid pressure, obesity, female sex, headaches and migraine, fatigue, visual disturbances (visual acuity and eye motility abnormalities), vestibulocochlear disturbances (vertigo and neurosensorial hearing loss), and bodily pain (radicular pain and small-fiber neuropathy). Furthermore, challenge tests of the pituitary gland showed similar abnormalities in all three conditions: blunted adrenocorticotropic hormone, cortisol, growth hormone, luteinizing hormone, and thyroid stimulating hormone responses and an increased prolactin response. The findings of this narrative review provide further support for the hypothesis that moderately or intermittently increased cerebrospinal fluid pressure is involved in the pathogenesis of FM and CFS and should stimulate further research into the etiopathogenesis of these conditions.

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Case Report: Mixed-Cause Vertigo and Sudden Sensorineural Hearing Loss as Presentations of Vertebrobasilar Dolichoectasia

Rodríguez¹,

Ugalde²,

García-Tecpa³

2022

Cureus

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Sudden sensorineural hearing loss (SSNHL) is a syndrome characterized by rapid progression of hearing impairment over seconds to days. While no universally accepted definition exists, it is often defined as a sensorineural hearing loss of 30 decilbles (dB) or more across at least three contiguous frequencies, occurring within 72 hours.In elderly patients and those with vascular risk factors who develop SSNHL, ischemia of the vertebrobasilar territory is suspected, especially of the anteroinferior cerebellar artery. This is because ischemia that affects this artery produces 79% of SSNHL associated with cerebral infarction. In many cases of ischemia of the vertebrobasilar territory, there is an association with anomalies of the vertebrobasilar circulation, such as vertebral artery hypoplasia or vertebrobasilar dolichoectasia.Here, we report a case of a 73-year-old man who presented right sudden hearing loss accompanied by acute onset vertigo, a physical exploration compatible with right vestibular dysfunction, and a history of recurrent episodes of syncope in the context of vertebrobasilar dolichoectasia, as diagnosed via magnetic resonance imaging (MRI).

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Análisis de la probabilidad conjunta y a posteriori entre aracnoidocele selar primario, sus comorbilidades y enfermedad audiovestibular

Abstract: Bayesian analysis and conditional probability enables the dependence between two or more variables to be calculated. In this study both mathematical models were used to analyse comorbidities and audiovestibular disorders in patients diagnosed with primary empty sella.

Cited by 3 publications

References 19 publications

Diagnostics and the combined medical tactics at patients with erectile dysfunction at a empty sella syndrome

Diagnostics and the combined medical tactics at patients with erectile dysfunction at a empty sella syndrome

The Link Between Empty Sella Syndrome, Fibromyalgia, and Chronic Fatigue Syndrome: The Role of Increased Cerebrospinal Fluid Pressure

Case Report: Mixed-Cause Vertigo and Sudden Sensorineural Hearing Loss as Presentations of Vertebrobasilar Dolichoectasia

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