Penetrating orbitocranial injury to the sella: case report and review of the literature.
A 39-year-old woman sustained a self-inflicted transorbital penetrating injury that resulted in direct pituitary injury with hypopituitarism and decreased vision in the opposite eye. Several hormone deficiencies were detected. Even though this patient did not develop any other complications from her injury (abscess, cerebrospinal fluid fistula or pseudoaneurysm), after two years of follow-up no recovery of pituitary or visual function has occurred.


CONCLUSIONS
From our experience in this case, we propose a conservative multidisciplinary approach when dealing with this type of lesion. Broad spectrum antibiotic coverage and early detection and replacement of any hormone deficiency should be instituted.
Gonzalez-Cruz
Jorge
J
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Cardenas
Raul
R
Nanda
Anil
A
D000328:Adult; D005260:Female; D020197:Head Injuries, Penetrating / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007018:Hypopituitarism / Q000209:etiology; D009916:Orbital Diseases / Q000150:complications*; D016728:Self-Injurious Behavior / Q000150:complications*; D012658:Sella Turcica / Q000293:injuries*; D012886:Skull / Q000293:injuries*; D013974:Thyroxine / Q000627:therapeutic use; D014786:Vision Disorders / Q000209:etiology*
D013974:Thyroxine; D006854:Hydrocortisone