PMC5909097_01
(a) Presurgical contrast enhanced T1 Sagittal MR image of the pituitary gland showing macroadenoma. Post surgical images (b) Sagittal T2 (c) Coronal T2 and (d) Post contrast T1 weighted Coronal images of the pituitary gland showing residual gland and evident empty sella turcica with downward herniation of optic chiasm and suprasellar structures
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F1
She was diagnosed as having pituitary macroadenoma [Figure 1a] 8 months back for which she underwent endoscopic pituitary adenoma resection. Magnetic resonance imaging (MRI) of the brain showed evident empty sella turcica with downward herniation of optic chiasm [Figure 1b-d].
(a and b) Right and left eye visual field before LP shunt insertion (c and d) Right and left eye Visual field after LP shunt insertion. Visual field testing results obtained showed dramatic improvement of the preprocedural visual field defects
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F2
For long-term outcome, lumbar-peritoneal (LP) shunt was placed after a period of 1 month which resulted in both subjective and objective improvement in visual acuity [Figures 2 and 3].
(a and b) T1 and T2 weight MR images from the sellar region following Lumbar-Peritoneal shunt procedure shows a reversal of chiasmatic herniation and reduction in the degree of empty sella turcica
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F3
For long-term outcome, lumbar-peritoneal (LP) shunt was placed after a period of 1 month which resulted in both subjective and objective improvement in visual acuity [Figures 2 and 3].