title: Hypopituitarism caused by carotid cavernous fistula.
abstract: Here we report a 79-year-old woman who presented with a 7-day history of headache, nausea, vomiting, and was found to have proptosis and ptosis. Laboratory findings showed hyponatremia, hypocortisolism, secondary hypothyroidism and low follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. CT angiography (CTA) showed a vascular lesion in sella causing a mass affect on the pituitary gland which proved to be a carotid cavernous fistula (CCF) by conventional angiography. The lesion was subsequently treated with coil placement and patient's hyponatremia was successfully treated with corticosteroid and thyroid hormone replacement. Though rare, CCF should be considered in the differential diagnosis of sellar lesions. Also, in patients with CCF hyponatremia, hypotension or signs of hypothyroidism should warrant a work-up for pituitary function.
authors.affiliation: Department of Medicine, Emory School of Medicine, U.S.A. ssadeg2@emory.edu
authors.forename: Shadi Sadeghi
authors.initials: SS
authors.lastname: Yarandi
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Khoshnoodi
authors.forename: Prakash
authors.initials: P
authors.lastname: Chandra
mesh_terms: D000368:Aged; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D007018:Hypopituitarism / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed