Reversible empty sella in idiopathic intracranial hypertension: an indicator of successful therapy?

Idiopathic intracranial hypertension is commonly associated with an empty sella, caused by herniation of subarachnoid cerebrospinal fluid through an absent or patulous diaphragma sellae. We describe the findings in two patients who presented with headache, papilledema, and visual disturbances. Diagnosis of idiopathic intracranial hypertension was made on the basis of clinical symptoms and laboratory data. Initial imaging studies in each patient showed an empty sella. After treatment, one with acetazolamide and the other with lumboperitoneal shunting, the appearance of the sellar contents became normal.