Analysis of the joint and a posteriori probability between primary empty sella, its comorbidities and audiovestibular pathology

Delgado-Hernández, Alhelí; Verduzco-Mendoza, Antonio; Luna-Reyes, Francisco Alfredo; Márquez-Palacios, Salvador; Arch-Tirado, Emilio

doi:10.1016/j.circen.2015.11.007

Cited by 7 publications

(13 citation statements)

References 20 publications

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“…This diaphragm also allows the pituitary stalk to pass through a very small opening in its center. Incompetence of the sellar diaphragm is considered crucial in the formation of PES and has been demonstrated in 22-77% of cases, while a total absence of diaphragm sella has been reported in 20.5% of normal subjects (20). Increased pressure in the suprasellar subarachnoid space or pituitary volume reduction predispose to the development of an intrasellar subarachnoid hernia.…”

Section: Sellar Diaphragm Deficiencymentioning

confidence: 99%

“…Instead, in women in the fourth decade of life, pituitary involution is associated with menopause, which explains why PES syndrome predominates in middle-age women. On some occasions, in cases of primary hormonal deficiency (such as primary hypothyroidism, primary hypoadrenalism and primary hypogonadism), a compensatory pituitary hypertrophy occurs (20). At least, also in hypophysitis, which represents an emerging and more frequently diagnosed disease (34), pituitary hyperplasia could evolve in empty sella, as last stage of disease, as suggested by the presence of antipituitary antibodies in around 6% of PES cases (35).…”

Section: Pituitary Factorsmentioning

confidence: 99%

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DIAGNOSIS OF ENDOCRINE DISEASE: Primary empty sella: a comprehensive review

Chiloiro¹,

Giampietro²,

Bianchi³

et al. 2017

European Journal of Endocrinology

128

149

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Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degrees of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanisms are not well known but seem to be due to a sellar diaphragm incompetence, associated to the occurrence of upper sellar or pituitary factors, as intracranial hypertension and change of pituitary volume. As PES represents in a majority of cases, a neuroradiological findings without any clinical implication, the occurrence of endocrine, neurological and opthalmological symptoms, due to the above describes anatomical alteration, which delineates from the so called PES syndrome. Headache, irregular menses, overweight/obesity and visual disturbances compose the typical picture of PES syndrome and can be the manifestation of an intracranial hypertension, often associated with PES. Although hyperprolactinemia and growth hormone deficit represent the most common endocrine abnormalities, PES syndrome is characterized by heterogeneity both in clinical manifestation and hormonal alterations and can sometime reach severe extremes, as occurrence of papilledema, cerebrospinal fluid rhinorrhea and worsening of visual acuity. Consequently, a multidisciplinary approach, with the integration of endocrine, neurologic and ophthalmologic expertise, is strongly advocated and recommended for a properly diagnosis, management, treatment and follow-up of PES syndrome and all of the related abnormalities.

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Section: Sellar Diaphragm Deficiencymentioning

confidence: 99%

Section: Pituitary Factorsmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Primary empty sella: a comprehensive review

Chiloiro¹,

Giampietro²,

Bianchi³

et al. 2017

European Journal of Endocrinology

128

149

View full text Add to dashboard Cite

show abstract

“…Sellar arachnoidocele is an imaging finding in which it is possible to see a herniation of the subarachnoid space in to the hypofisiary cavity, thereby resulting in the entrance of the arachnoid and cerebrospinal fluid into this cavity [11,12]. According to its etiology, this can be classified as primary if there is no pathological process that causes hypofisiary damage.…”

Section: Aica: Antero-inferior Cerebellar Artery Scc: Semicircular Canalmentioning

confidence: 99%

“…Otherwise, secondary arachnoidocele is more frequent and is caused by pathological processes in the said region. Inside these mechanisms, we can include head trauma (such is the case in our patient), postpartum hemorrhage, thrombosis, meningitis, hypofisiary infarctions, surgical procedures, hydrocephalus, tumors, thrombosis, meningitis, and radiotherapy among other causes [11,12]. This finding can be asymptomatic or can exhibit an "empty sellar syndrome," characterized by neurological, endocrine, ophthalmologic, audiologic, and vertiginous impairments [11,12].…”

Section: Aica: Antero-inferior Cerebellar Artery Scc: Semicircular Canalmentioning

confidence: 99%

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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“…Regarding pathophysiology and etiology, ESS is subdivided into two categories: primary ESS (PES) and secondary ESS (SES). PES occurs when there is increased CSF pressure alongside a defect in the diaphragma sellae [2,3,6,[8][9][10]. While there is no clear genetic association known to cause a predisposition to PES, it is likely that the incompetent diaphragma sellae was present at the patient's birth [3].…”

Section: Introductionmentioning

confidence: 99%

Adrenal Insufficiency due to Total Primary Empty Sella Syndrome

et al. 2020

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A 64-year-old woman was transported suffering from persistent lower abdominal pain, vomiting, and low-grade fever. Magnetic resonance imaging revealed an empty sella (ES) and hormone tests revealed a disappearance of diurnal variation of cortisol, low cortisol and adrenocorticotropic hormone (ACTH) secretion especially in the morning, and poor ACTH-cortisol axis reaction, as well as normal hypothalamus-pituitary gland-thyroid or adrenal gland axis hormone reaction. The cause of ES remained unclear; however, based on a diagnosis as adrenal insufficiency due to inappropriate ACTH secretion caused by total primary ES syndrome, we started hydrocortisone (15 mg/ day). Afterwards, she immediately became symptom-free and was discharged.

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Analysis of the joint and a posteriori probability between primary empty sella, its comorbidities and audiovestibular pathology

Cited by 7 publications

References 20 publications

DIAGNOSIS OF ENDOCRINE DISEASE: Primary empty sella: a comprehensive review

DIAGNOSIS OF ENDOCRINE DISEASE: Primary empty sella: a comprehensive review

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

Adrenal Insufficiency due to Total Primary Empty Sella Syndrome

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