Enlargement of the sella turcica in pseudotumor cerebri

Abstract

Object. The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. Methods. The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patients were selected from the same practice. The sella turcica and pituitary gland were measured on sagittal T1-weighted MR images. Results. Measurements were obtained for 48 patients with pseudotumor cerebri and 48 controls. The cross-sectional area of the sella was 38% greater in the patients with pseudotumor cerebri, with only a slight reduction in mean pituitary gland size. Conclusions. Chronic elevation of intracranial pressure is associated with bony enlargement of the sella turcica. Enlargement of the sella turcica contributes to its partially empty appearance.

Enlargement of Meckel's cave in patients with spontaneous cerebrospinal fluid leaks

“…Kyung et al. proposed that the appearance of the empty sella was secondary to bony enlargement and expansion of the sella turcica . Other detectable changes in imaging considered major signs in the diagnosis of IIH include dilation of the optic nerve sheath and flattening of the posterior aspect of the globe .…”

Pituitary morphovolumetric changes in Alström syndrome

“…Unlike what supposed for pseudotumor cerebri [11], the lack of correlation of AS empty sella with the BMI does not support the hypothesis of increased intracranial pressure due to overweight. The increased frequency of empty sella with age seems to support a degenerative process that could be sustained by defective hypothalamic function or by an accelerated ageing process.…”

Body Mass Index and Olfactory Fossa Depth in Patients with and without Spontaneous Cerebrospinal Fluid Leaks

“…Elevated CSF pressures have been documented postoperatively in patients who have undergone SCSF leak repair [2]. Bony sellar expansion can be found in some patients with IIH, presumably due to the elevated CSF pressures [4,5]. Thus, there are links between obesity and IIH, elevated CSF pressures and SCSF leaks, and observations of skull base bony expansion at the sella in patients with IIH.…”

“…In addition to empty sella syndrome, some patients with IIH develop bony sellar expansion [4,5]. The sella is a weak point in the skull base, and the effects of constant elevated pressure against the sellar bone results in bony remodeling and expansion, as is commonly seen in patients with pituitary macroadenomas and other sellar neoplasms [5]. Common sites of SCSF leaks represent other weak areas of the skull base and include the tegmen and the cribriform plate.…”