Diagnosis of empty sella with small amounts of air at computed tomography

The incidental finding of an enlarged sella turcica on a skull roentgenogram may precipitate a tedious, expensive endocrinological as well as invasive radiological evaluation of an asymptomatic patient. Computed tomography and metrizamide cisternography have been suggested as alternatives to traditional pneumoencephalography. We have found the most direct and definitive study of the "empty sella" to be limited computed tomography after the introduction of a small amount of air by lumbar puncture. The diagnosis is made quickly without morbidity.