[Fracture of the sella turcica--a case report and review of the literature].
The incidence of a fracture of the sella turcica is reported to be rare and the authors reported a case of a sellar fracture associated with several neurological and endocrinological complications. A 16-year-old boy was struck at the face and the forehead on the road in a motorcycle accident and was hospitalized in a confusional state. Neurological examinations showed dilatation of the both pupils, sluggish light reflex on both sides and bilateral oculomotor palsy but motor weakness or sensory disturbance was not present. On the tenth hospital day, he developed diabetes insipidus and endocrinological examinations disclosed the impairment of GH, LH and FSH reserves, too. Neuroradiological examinations disclosed fractures of bilateral frontal bones and fractures of the left optic canal and ethmoidal roof as well as a fracture of the sella turcica. On the 28th hospital day, he also developed CSF rhinorrhea and pneumocephalus. Surgical repair for the CSF rhinorrhea was performed. Fractures of the sella turcica were reviewed in 23 cases including our personal case and a special consideration regarding the mechanism of sellar fractures and their major complications was made. The authors stressed the early recognition of a fracture of the sella turcica in head injuries, which would suggest a severe hypothalamo-pituitary involvement or other neurological disorders.
D000293:Adolescent; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D003919:Diabetes Insipidus / Q000209:etiology; D005640:Follicle Stimulating Hormone / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D010903:Pituitary Gland, Anterior / Q000503:physiopathology; D011007:Pneumocephalus / Q000209:etiology; D012658:Sella Turcica / Q000293:injuries*; D012887:Skull Fractures / Q000097:blood / Q000150:complications*
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013006:Growth Hormone