Presentation
Headache, dizziness, and to exclude an intracranial mass
Patient Data
There is an expanded sella turcica, and CSF signal intensity fills the pituitary fossa with shrinking or atrophied pituitary gland.
The infundibulum traverses the pituitary fossa without displacement down to the floor of the sella indicating no mass within.
There is a halo of hyperintense signal in T2 and FLAIR around the lateral ventricles, denoted by small vessel periventricular ischemic disease rather than obstructed hydrocephalus.
Circumferential mucosal wall thickening of the right sphenoid sinus with the hyperintense signal by T2 and FLAIR denoted sinusitis.
Case Discussion
The finding of an empty sella in isolation may be normal (particularly in older patients like our case). The headache, in this case, may related to chronic sphenoid sinusitis.
Most patients with empty sella are entirely asymptomatic.
Idiopathic intracranial hypertension can result in an empty sella, but without other associated imaging findings, that is not the case here.
Contributor: yemeni gastrohepatologist Prof Dr Naser Mohammed Salah.
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