Traumatic lesions of the suprasellar region: MR imaging

The authors studied nine patients with injuries to the suprasellar region with 1.5-T magnetic resonance (MR) imaging. Five patients had chiasmal injuries diagnosed by means of clinical examination. MR imaging demonstrated complete transection in two of these five patients, contusion of the chiasm by inferior herniation of the gyrus rectus in one, and a normal chiasm in two. Two patients had large tears of the floor of the third ventricle resulting in wide communication between the third ventricle and the prepontine cistern. One of these patients also had an avulsed third nerve. Transection of the pituitary stalk was seen in two patients. MR imaging can demonstrate injuries to the suprasellar structures. The MR imaging appearance of optic chiasm correlates with different types of injury to the chiasm described in the clinical literature and may alleviate the need for additional diagnostic studies to help explain the patient's symptoms.