title: Intrasellar abscess following transsphenoidal surgery.
abstract: BACKGROUND
  Intrasellar abscess following transsphenoidal surgery has been described only twice in the English language medical literature. Overall mortality associated with intrasellar abscesses is 51%, while mortality in reported cases not treated surgically is 100%.
  
  
  METHODS
  Two cases of intrasellar abscess following uncomplicated transsphenoidal surgery for pituitary pathology are reported. The incidence, radiographic features, clinical presentations, and treatment of intrasellar abscesses are discussed.
  
  
  RESULTS
  Both patients described underwent uncomplicated transsphenoidal procedures for treatment of a primary pituitary lesion. Neither developed postoperative CSF rhinorrhea, and initial recovery was uneventful. The first patient presented with new symptoms several weeks after transsphenoidal surgery; the second patient almost two years postoperatively. The first displayed signs of an expanding sellar mass, requiring transsphenoidal drainage and postoperative antibiotics. The second presented with recurrent meningitis without discernible CSF leak, and was treated with transnasal endoscopic drainage in conjunction with antibiotic therapy.
  
  
  CONCLUSIONS
  The high mortality associated with intrasellar abscess mandates its inclusion in the differential diagnosis of patients presenting with symptoms of meningitis or an expanding sellar mass after transsphenoidal intervention. Although antibiotic therapy is an important adjunct, surgical drainage is required for definitive treatment.
authors.affiliation: Department of Neurological Surgery, Washington University, St. Louis, Missouri, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Henegar
authors.forename: M B
authors.initials: MB
authors.lastname: Koby
authors.forename: D L
authors.initials: DL
authors.lastname: Silbergeld
authors.forename: K M
authors.initials: KM
authors.lastname: Rich
authors.forename: C J
authors.initials: CJ
authors.lastname: Moran
mesh_terms: D001922:Brain Abscess / Q000175:diagnosis* / Q000209:etiology*; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012658:Sella Turcica; D013100:Sphenoid Bone / Q000601:surgery