Sheehan's Syndrome with Edema in Optical Neural Sheaths: A Case Report

Abstract

Sheehan syndrome is partial or complete hypophyseal insufficiency due to hypophyseal necrosis secondary to postpartum hemorrhage and hypovolemia. Clinical findings are cessation of lactation, secondary amenorrhea, loss of libido and hypophyseal reserve loss. Treatment is hormone replacement. Forty-four years old women admitted with somnolence, malaise, edema and blurred vision. Physical examination revealed edema and hypotension. She had massive bleeding during her birth 11 years old ago; therefore she had received blood transfusion and could not breast-feed then. She had amenorrhea when she admitted. She was diagnosed to be Sheehan syndrome while glucocorticoid and levothyroxine replacement was started. Hypophyseal and orbital magnetic resonance imaging revealed empty sella and edema in bilateral optical neural sheaths respectively. Empty sella may cause edema in optical neural sheaths by increasing pressure in subarachnoidal space. We present this case to point out this coincidence. [Cukurova Med J 2013; 38(2.000): 299-304]

Keywords

• Sheehan syndrome
• optic nerve
• empty sella
• magnetic resonance imaging