Empty sella syndrome with gyrus rectus herniation

case report and literary review.

Abstract

Introduction: Although the knowledge about empty saddle syndrome is quite vast and documented in the literature, there are few studies clarifying the procedures applied in reported cases, the diagnostic difficulties, and the intervention techniques, besides the results obtained. Objectives: To report the case of a young patient with empty saddle syndrome with herniation of girus retus, through a retrospective review of the medical record correlating clinical and surgical aspects. Method: A retrospective review of the patient’s medical record was realized. Case report: A 17-year-old patient initially presented with symptoms of endocrine origin characteristic of hypocortisolism and hypogonadism. Image exam showed the presence of a Turcic saddle without the usual pituitary contents, but with the presence of herniation of girus retus. Surgical treatment was indicated and there was a significant improvement in hypotension, and it was necessary to associate hormone replacement therapy with treatment. Discussion: The empty saddle syndrome is characterized by the herniation of the arachnoid membrane into the turcic saddle, that can act with mass effect, taking pituitary function to failure. The clinical status will depend on the etiological factor, usually requiring hormone replacement for these patients and in some cases surgical intervention. Conclusion: SSV is an important pathology that should always be among the differential diagnoses in patients with hypogonadism clinic.