I just posted the following in the general neurology section - then I found this forum, and so since it pertains to Arnold Chiari I am reposting it here. Hope it is okay to do so. Here is the situation:
Can Arnold Chiari cause Empty Sella Syndrome?
I was diagnosed 5 years ago with Arnold Chiari Malformation Type 1. The symptoms at that time were for the most part attributed to my cervical spine. After nearly a year, things improved and I moved on.
Last summer I began having severe headaches which felt like extreme pressure in my forehead, and sharp pain in my temples.
An initial MRI in October showed Sella Region was clear.
A subsequent MRI two months ago in March showed a Pituitary Macroadenoma at 1.4cm.
A follow up MRI with contrast a month later in April indicated there was no tumor, but there was predominant Cerebral Spinal Fluid intensity within the Sella.
In between the March MRI which found the Tumor and the April MRI which declared it not there, I began to have brief incidents of double vision along with other symptoms I had been having such as the headaches, and facial numbness.
Surgeon says there was no tumor, that a mistake was made and that what I have is "Empty Sella Syndrome". I do not fit the profile for the birth defect type as I have never been obese or suffered from high blood pressure. Although rapid weight gain did occur in the months preceding the headaches, as did a slight elevation in blood pressure. But this weight is falling off as rapidly as it came on: I have lost twenty two pounds with little to no effort since Febuary. So I have many symptoms I am not going to go into here because I am trying to keep this brief, and I also have many questions as I am in limbo - Neurologist dismissed himself from my case after repeated errors, and I have been referred to a new Neurologist which I am currently waiting to see but it leaves me in limbo without answers. For the most part, to start with, I am questioning now three things:
1.) Did they allow the tumor/cyst to go too long and so it ruptured leaving me with the back up of spinal fluid in my sellla? How can I know whether or not this happened? Are there clinical signs/indicators?
2.) If there was no tumor and it was just a mistake, could it be the Arnold Chiari malformation that I know for certain I have, that has caused the Empty Sella/Cerebral Spinal Fluid build up?
3.) Can "predominant Cerebral Spinal Fluid intensity" in my now empty sella cause the same mass effect symptoms as a tumor in the Sella?
I could go on in detail about a variety of symptoms, but am trying to keep this brief. I do know that I also have osteoarthritis in my spine, but I don't think this causes Cerebral Spinal Fluid build up in my brain/sella, nor as far as I know it doesn't affect the cranial nerves either. (Facial Numbness and double vision episodes). Other symptoms in general include muscle spasms, tingling and numbness, at times involuntary jerking, and hormonal imbalance symptoms.
Thanks in advance for any insight,
Kat
P.S... Also, both MRI'S from March and April indicate first "Unspecified Periventricular and Subcortical White Matter Changes" (in March when Tumor was diagnosed). Second MRI in April where tumor was missing states "small foci of periventricular white matter hyperintense T2 signal". Are these white matter issues significant? At no point did the Neurologist that quit my case ever even mention them.