The structure of the human brain is very complex, each of the departments performs an important function. The development of pathologies in this vital organ entails a sharp deterioration in the state of health. One of these diseases is the syndrome of the Turkish saddle.
What is the empty Turkish saddle in the brain
This name is due to its shape, it looks like a depression in the sphenoid bone with a kind of back like a saddle. This area is located under the hypothalamus, on both sides of it are optic nerves. Through this place go the carotid arteries to the base of the box and then there is a venous sinus. Here arterial pool is formed, which is the main source of blood for both hemispheres of the brain. The pituitary gland spreads through the walls of the cavity of the Turkish saddle, if the brain is protruding due to a violation of one of the functions:
- neurologic;
- of the neuroendocrine;
- neuro-ophthalmologic.
Causes of the syndrome of the Turkish saddle
The Turkish saddle in the brain can be primary and secondary. The first variant of the disease occurs suddenly without obvious and obvious reasons. The secondary empty saddle becomes a consequence of pituitary disease, hypothalamus or the result of their treatment. The cause of the disease in most cases is the underdeveloped diaphragm of the Turkish saddle. Under the influence of internal factors, the soft meninges can spread into its cavity.
In such conditions, the vertical size of the pituitary gland is formed, pressing it to the bottom and walls of the saddle occurs. Physicians identify several factors that can cause and significantly increase the risk of the disease, for example:
- Increased intracranial pressure. With pulmonary or cardiac insufficiency, tumors, craniocerebral trauma, arterial hypertension, the risk of developing a Turkish saddle in the brain increases.
- Hyperplasia of the pituitary gland and its legs. This pathology is manifested, as a rule, with prolonged intake of oral contraceptives. In girls, this condition can be caused by frequent pregnancies.
- Endocrine restructuring provokes transient hyperplasia of the pituitary gland. It is observed at pubertal age, during pregnancy or when it is interrupted.
- Tumors of the brain, their necrosis. Frequent operations that are carried out on the same sites or nearby, lead to an increased risk of developing the syndrome of the Turkish saddle.
When diagnosing and establishing the root cause, it is mandatory for specialists to determine the type of syndrome - primary or secondary. This is important, because they develop for various reasons, for example, the primary syndrome of the Turkish saddle. In this case, there is underdevelopment, weakening of the walls of this region from below. Such a state is developing rapidly under the influence of the following factors:
- with pulmonary or cardiac insufficiency rises, blood, intracranial pressure, which can cause osteoporosis of the Turkish saddle;
- increase in the size of the pituitary gland, which is the coordinator of all endocrine processes of the body;
- the appearance of cavities with fluid, leading to death, a pituitary tumor.
Secondary syndrome of the Turkish saddle looks a little different. In this case, the development of the disease is due to the presence of pathologies of the hypothalamic-pituitary nature. All diseases that are localized to the areas of the brain where the pituitary gland is located belong to them. Another factor in the development of the secondary type may be neurosurgical interventions, which are carried out in the areas of the brain where the Turkish saddle is located.
Symptomatic of the emerging empty Turkish saddle
Specialists note that the symptoms that can accompany an empty Turkish saddle are diverse, depend on the type and extent of disruption in the function of hormone release, the pituitary gland. As a rule, the development of the disease is accompanied by such signs:
- regular headaches;
- double vision;
- fuzziness, fog before the eyes;
- frequent dyspnea;
- dizziness;
- increased body temperature;
- fast fatigue;
- reduced performance, physical endurance;
- pain in the thoracic region;
- high blood pressure;
- dry skin;
- nail brittleness.
Ophthalmic signs
Depending on the nature of the symptomatic manifestations, a person can refer to a particular specialist. The following signs become the basis for applying to the ophthalmologist:
- diplopia;
- macular degeneration - loss of visual fields;
- retrobulbar pains - painful sensations when moving eyeballs, often accompanied by tearing, migraine;
- photopsy - black dots in front of the eyes;
- the blurring of the view;
- chemosis - swelling of the conjunctiva of the eye.
Neurological
Neurological symptoms that indicate the development of an empty Turkish saddle of the brain include the following manifestations:
- a constant low-grade fever;
- attacks of tachycardia, dyspnea, chills, fainting;
- irritability, emotional depression, unreasonable fear;
- regular non-localized head pain;
- spasmodic pain that occurs suddenly, limb cramps;
- blood pressure changes.
Endocrine system abnormalities
To the development of the empty Turkish saddle from the endocrine system, there may be signs that result from an overabundance of pituitary hormones:
- malfunctions of menstrual cycles( in women);
- enlarged thyroid;
- sexual dysfunction;
- acromegaly - expansion of body parts;
- diabetes insipidus;
- metabolic problems.
Diagnosis of the disease
As a rule, a person turns to a profile doctor according to the manifested symptoms. If problems with eyesight, then you should go to the ophthalmologist, with violations in the hormonal plan - to the endocrinologist. Any of them can prescribe additional tests that can identify the root cause of the problems. Identify in the brain empty Turkish saddle helps magnetic resonance imaging. In some cases, an expert may suspect this disease in the study of venous blood, where there is a marked change in the rate of hormones that the pituitary gland produces.
Radiography of the skull
The X-ray of the Turkish saddle is extremely rare, because it does not give a 100% clear picture, according to which the doctor can confidently make a diagnosis. As a rule, the survey radiography of the skull, which was assigned to diagnose craniocerebral injuries or sinusitis, can reveal the pathology of the space of the Turkish saddle. In this case, the doctor appoints an MRI to confirm the diagnosis.
MRI of Turkish saddle with contrasting
At the moment the most accurate way to make an accurate diagnosis with suspicion of the Turkish saddle of the brain is magnetic resonance imaging. Pictures obtained by this method of diagnostics have high quality, accuracy, which allows to study all the smallest details. In difficult cases, a contrast agent may be used, which is administered intravenously before the procedure. It is absolutely harmless to the human body and is a contrast that "highlights" the pathology sites.
Treatment of the syndrome of the empty Turkish saddle
The purpose of the course of therapy depends entirely on the underlying cause, against which the development of the Turkish saddle syndrome began. Treat, as a rule, the underlying disease, and also suppress the manifestation of symptoms. Separate treatment options can be divided into two main groups - medications and surgical intervention. Therapy with folk remedies for this type of disease is not carried out.
Medicated
When a Turkish saddle is found in the brain during a test for another disease, usually no treatment is prescribed. In these cases the pathology does not manifest itself in any way, does not cause discomfort. It is only necessary to have a regular check-up with a doctor, so as not to miss the aggravation of the condition. In other cases, the following principles are guided:
- With hormonal failures, when there is a deficit in the production of specific hormones, prescribe substitution therapy. It consists in managing the missing elements from the outside.
- Asthenic, vegetative problems are solved with the help of symptomatic treatment. The doctor may prescribe sedatives, pain medications or medications to lower blood pressure.
Surgical
Surgery for leakage of cerebrospinal fluid with thinning of the bottom of the Turkish saddle in the nasal cavity. The same method of treatment is necessary for the sagging of the visual intersection in the diaphragm and the compression of the optic nerves, which leads to disturbances in the visual fields. After the procedure, the patient should undergo a course of radiotherapy and hormone replacement therapy. There are two methods of performing a surgical operation of a Turkish saddle in the brain:
- Through the frontal bone. This kind is used in the presence of a large tumor, which does not allow the use of removal through the nose. This method is more traumatic.
- Through the nose. More common variant of the operation. In the nasal septum an incision is made through which all other manipulations are performed.