The authors present the unusual case of a 15-year-old boy with a primary empty sella caused by non-communicating hydrocephalus due to fourth ventricle outflow obstruction whose secondary symptoms of growth hormone deficiency and delayed puberty were successfully treated by endoscopic third ventriculocisternostomy (ETV). Hypopituitarism occurs only rarely in cases of hydrocephalus; rarer still are cases where hypopituitarism is the sole symptom of hydrocephalus. A primary empty sella may indicate elevated intracranial pressure; if the cause is non-communicating hydrocephalus, ETV is indicated as the preferred treatment modality.

Department of Neurosurgery University Hospital Ostrava 17 Listopadu 1790 5 70852 Ostrava Czech Republic

Endocrinology outpatients clinic Hospital Frýdek Místek Frýdek Místek Czechia

Faculty of Medicine University of Ostrava 17 Listopadu 1790 5 70852 Ostrava Czech Republic

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