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Skull changes with intrasellar cisternal herniation (empty sella)

X Bajraktari

    Neuroradiology
    |April 18, 1977
    PubMed
    Summary

    Intrasellar cisternal herniation, or empty sella, can often be suspected with skull X-rays. Further imaging is needed for diagnosis, but X-rays may predict herniation type and intracranial pressure signs.

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    The empty sella syndrome--intrasellar cisternal herniation--in "normal" patients and in patients with communicating hydrocephalus and intracranial tumors.

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    Area of Science:

    • Radiology
    • Neurosurgery
    • Neuroradiology

    Background:

    • Intrasellar cisternal herniation, commonly known as empty sella, is a condition where cerebrospinal fluid extends into the pituitary fossa.
    • This condition can be associated with various symptoms and may mimic other sellar pathologies.

    Purpose of the Study:

    • To review cases of intrasellar cisternal herniation diagnosed using plain skull X-rays and pneumoencephalography.
    • To evaluate the diagnostic utility of plain X-rays in identifying empty sella and predicting herniation characteristics.

    Main Methods:

    • Retrospective review of 47 cases diagnosed with intrasellar cisternal herniation.
    • Analysis of plain skull X-ray findings and pneumoencephalography results.
    • Correlation of radiological findings with herniation type (horizontal, anterior, complete) and signs of increased intracranial pressure.

    Main Results:

    • Plain X-ray findings can frequently suggest the diagnosis of empty sella.
    • The appearance of the sella on X-ray may help anticipate the type of intrasellar herniation.
    • Approximately half of the cases exhibited signs of increased intracranial pressure, primarily erosion of the dorsum sellae.

    Conclusions:

    • While plain skull X-rays can raise suspicion for intrasellar cisternal herniation, further diagnostic studies are essential for confirmation.
    • Radiographic assessment of the sella morphology can provide insights into the type and extent of herniation.
    • The presence of increased intracranial pressure signs should be considered in the evaluation of empty sella patients.

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