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Case Report
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| Sexual dysfunction as the initial clinical feature of a massive intrasphenoidal meningoencephalocele: A case report | ||||||
| Chi-Man Yip1, Jui-Hsun Fu2, Shu-Shong Hsu1 | ||||||
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1MD, Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
2MD, Department of Radiology, Section of Neuroradiology Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. | ||||||
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| How to cite this article |
| Chi-Man Y, Jui-Hsun F, Shu-Shong H. Sexual dysfunction as the initial clinical feature of a massive intrasphenoidal meningoencephalocele: A case report. Int J Case Rep Images 2016;7(12):815–818. |
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Abstract
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Introduction:
Trans-sphenoidal encephaloceles comprise less than 5% of all basal meningo-encephaloceles, which represent a rare clinical entity with wide range of symptoms in adult. Headache, endocrine alternations, visual field defects or other visual alternations, CSF leakage are the possible clinical features. CSF leakage and visual deficit are the two clinical indications for surgery.
Case Report: A 38-year-old male presented to us with the chief complaint of sexual dysfunction detected after marriage. His sellar magnetic resonance imaging (MRI) showed a large cystic lesion without obvious enhancement located in the sellar region as well as sphenoid sinus on regular T1-weighted, T2-weighted and T1-weighted with Gadolinium images. The cine phase-contrast and 3D FIESTA series disclosed the descent of anterior floor of 3rd ventricle including infundibular recess and optic recess with expansion of the descending portion of 3rd ventricle and herniation of optic chiasm into sella turcica and sphenoid sinus. A massive intrasphenoidal meningoencephalocele with panhypopituitarism, hypogonadism and hyperprolactinemia as well as optic neuropathy was diagnosed and he underwent endoscopic endonasal transsphenoidal chiasmapexy in order to release the stretching on the herniated suprasellar visual system and hormone therapy after surgery to manage his endocrinological disorders. Conclusion: Magnetic resonance imaging (MRI) scan of sella is essential in evaluation of trans-sphenoidal encephalocele to confirm the extent of lesion, the possible associated abnormalities and to plan for the safest approach. In addition, cine phase-contrast MRI scan can differentiate the meningo-encephalocele from other cystic lesions in the sellar region and three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequence can delineate the suprasellar visual system well before operation. | |
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Keywords:
Cine phase-contrast MRI scan, Endoscopic endonasal transsphenoidal chiasmapexy, Suprasellar visual system, Three-dimensional fast imaging employing steady-state acquisition, Trans-sphenoidal meningoencephaloceles
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Author Contributions
Chi-Man Yip – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Jui-Hsun Fu – Substantial contributions to conception and design, Analysis and interpretation of data, Revising the article critically for important intellectual content, Final approval of the version to be published Shu-Shong Hsu – Substantial contributions to conception and design, Revising the article critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Chi-Man Yip et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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