Relationship of Optic Chiasm to Sella Turcica and Pituitary Stalk: Correlation of Cadaveric and Imaging Findings

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Christoph Griessenauer ◽  
Joel Raborn ◽  
Martin Mortazavi ◽  
Shane Tubbs
Keyword(s):  
Sella Turcica ◽  
Optic Chiasm ◽  
Pituitary Stalk ◽  
Imaging Findings ◽  
Relationship Of

Endoscopic anatomy of the sphenoid sinus

1999 ◽  
Vol 113 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Samy Elwany ◽  
Ibraheim Elsaeid ◽  
Hossam Thabet
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Clinical Importance ◽  
Sinus Surgery ◽  
Endoscopic Anatomy ◽  
Relationship Of ◽  
The Relationship ◽  
Sphenoid Sinuses

AbstractThe anatomy of the sphenoid sinus, as it relates to endoscopic sinus surgery, was studied in 93 cadaver heads (186 sphenoid sinuses) using endoscopic dissections as well as sagittal sections. The relationship of the sphenoid sinuses to the carotid artery, optic nerve, floor of sella turcica, as well as other important structures, were verified and discussed. The recesses of the sinus as well as its ostium and accessory septa and crests were described and their clinical importance was discussed. Pertinent measurements were included wherever appropriate.

Extra pituitary midline structural abnormalities associated with ectopic posterior pituitary detected on a new rapid MR protocol (FAST1.2)

2021 ◽  
Author(s):  
Arthur Lyra ◽  
Daniel de Faria Guimarães ◽  
Altino Sá Meira ◽  
Arthur Castello Berchielli Nunes ◽  
Guilherme Vieira Peixoto ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Pituitary Stalk ◽  
Control Group ◽  
Hypothalamic Hamartoma ◽  
Pars Intermedia ◽  
Posterior Pituitary ◽  
Pineal Cyst ◽  
Imaging Results ◽  
Structural Abnormalities ◽  
Ectopic Posterior Pituitary

Abstract Background Ectopic posterior pituitary (EPP) is a malformation of the hypothalamic-pituitary region. Our goal was to describe midline structural brain abnormalities in patients with EPP using a dedicated protocol (FAST1.2 protocol) of magnetic resonance imaging (MRI) to evaluate the hypothalamus and pituitary gland, highlighting their clinical-laboratory correlations. Methods A cross-sectional study of patients diagnosed with EPP, and a control group. All individuals were submitted to a dedicated MRI protocol called FAST1.2, which combines the FAST1 protocol developed by our group with 3D T2DRIVE imaging. Results We evaluated 36 individuals with EPP and 78 individuals as a control group. One patient had two posterior pituitary lobes, one inside the sella turcica and the other along the pituitary stalk; in five patients, the EPP was along the pituitary stalk; in 28 the EPP was at the infundibular recess of the third ventricle, and in two the EPP was hypothalamic. In the EPP group, eleven individuals had interhypothalamic adhesion (IHA), three septo-optic dysplasia, one a cerebellar malformation, and one a pineal cyst. We did not observe a higher frequency of severe hormonal deficiency or developmental delay in patients with IHA. In the control group, eleven patients had a pineal cyst, three pars intermedia cysts, one hydrocephalus, and one hypothalamic hamartoma. Conclusion FAST1.2 acquisition allows confident recognition of regional anatomy and recognition of midline structural abnormalities on T2DRIVE, particularly including the pituitary stalk and IHA, thereby making MRI acquisition faster with no need for intravenous contrast administration. We suggest that IHA could be associated with defects in neuronal migration, as might occur in patients with EPP.

scholarly journals Sphenoid Sinus Osteoma at the Sella Turcica Associated with Empty Sella: CT and MR Imaging Findings: Fig 1.

2008 ◽  
Vol 29 (3) ◽  
pp. 550-551 ◽  
Author(s):  
C.Y. Chen ◽  
S.H. Ying ◽  
M.S. Yao ◽  
W.T. Chiu ◽  
W.P. Chan
Keyword(s):  
Mr Imaging ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Empty Sella ◽  
Imaging Findings

The Relationship of Isotopic Bone Imaging Findings to Prognosis in Legg-Perthes Disease

1980 ◽  
Vol &NA; (150) ◽  
pp. 23???29 ◽  
Author(s):  
ROBERT L. FISHER ◽  
JIM W. RODERIQUE ◽  
DOUGLAS C. BROWN ◽  
JAMES A. DANIGELIS ◽  
M. B. OZONOFF ◽  
...  
Keyword(s):  
Perthes Disease ◽  
Bone Imaging ◽  
Imaging Findings ◽  
Relationship Of ◽  
The Relationship

Topographic variations of the optic chiasm and the pituitary stalk: a morphometric study based on midsagittal T2-weighted MR images

2014 ◽  
Vol 36 (8) ◽  
pp. 775-781 ◽  
Author(s):  
Hao Long ◽  
Song-tao Qi ◽  
Ye Song ◽  
Jun Pan ◽  
Xi-an Zhang ◽  
...  
Keyword(s):  
Optic Chiasm ◽  
Pituitary Stalk ◽  
Morphometric Study ◽  
Mr Images

Modified orbitozygomatic craniotomy for craniopharyngioma resection in children

2009 ◽  
Vol 4 (4) ◽  
pp. 345-352 ◽  
Author(s):  
Kiarash J. Golshani ◽  
Kirk Lalwani ◽  
Johnny B. Delashaw ◽  
Nathan R. Selden
Keyword(s):  
Sella Turcica ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Neurological Deficits ◽  
Endocrine Dysfunction ◽  
Prepontine Cistern ◽  
Institutional Review ◽  
Suprasellar Region ◽  
Transsphenoidal Operation ◽  
Brain Retraction

Object In this study, the authors evaluated the efficacy and safety of modified orbitozygomatic craniotomy for resection of craniopharyngioma in children. Methods A prospective, institutional review board–approved database was retrospectively reviewed for pediatric patients undergoing craniopharyngioma resection performed by a single surgeon. Results Ten patients underwent craniopharyngioma resection surgery between July 2000 and January 2006 (4 girls and 6 boys, ages 1.5–17 years). Nine patients presented to the authors' institution, and 1 patient was referred after surgery and radiation therapy were administered elsewhere. Nine patients presented with visual field deficits (2 with unilateral or bilateral light perception only) and 5 with endocrine dysfunction. Eight patients had large tumors that significantly displaced the optic chiasm and hypothalamus. All patients underwent a modified frontotemporal orbitozygomatic osteotomy in a single piece. The lamina terminalis was opened in 4 patients with third ventricular extension. One patient required a staged transsphenoidal operation to remove residual tumor in the sella turcica, and 1 patient underwent a contralateral subtemporal approach to resect a daughter lesion in the prepontine cistern. Complete radiographic resection was achieved in all patients. Follow-up averaged 55 months (range 12–95 months). Vision was improved in 8 patients and remained stable in 2. All patients had postoperative endocrine dysfunction. One patient experienced transient cranial nerve IV palsy and 1 suffered a small caudate stroke 5 months after surgery without sequelae. Two patients experienced polyphagia and weight gain without other symptoms of hypothalamic dysfunction. There were no other new neurological deficits. Conclusions Modified orbitozygomatic craniotomy provides excellent exposure of the suprasellar region with minimal brain retraction, allowing complete resection of craniopharyngiomas with good visual and neurological results.

Relationship of cerebral microbleeds to other imaging findings

2011 ◽  
pp. 71-78 ◽  
Author(s):  
Eric E. Smith ◽  
David J. Werring ◽  
Cheryl R. McCreary
Keyword(s):  
Cerebral Microbleeds ◽  
Imaging Findings ◽  
Relationship Of

scholarly journals Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function

1997 ◽  
Vol 3 (1) ◽  
pp. E1
Author(s):  
R. Bryan Mason ◽  
Lynnette K. Nieman ◽  
John L. Doppman ◽  
Edward H. Oldfield
Keyword(s):  
Postoperative Period ◽  
Cushing’S Disease ◽  
Pituitary Tumors ◽  
Optic Chiasm ◽  
Anterior Lobe ◽  
Pituitary Function ◽  
Pituitary Stalk ◽  
Cushing's Disease ◽  
Suprasellar Cistern ◽  
Transsphenoidal Resection

When the surgeon identifies an adenoma within the gland and selectively excises it, endocrine-active pituitary tumors are usually cured and pituitary function is preserved. Occasionally ectopic adenomas arise primarily in the pituitary stalk or arise superiorly in the midportion of the anterior lobe and extend upward within the stalk. To determine if these tumors can be selectively excised with preservation of pituitary function, the authors examined the outcome of selective adenomectomy in 10 patients with Cushing's disease with an ectopic adenoma originating in, and confined to, the stalk (four microadenomas) or an adenoma extending superiorly through the diaphragma sella and into the stalk (five microadenomas and one macroadenoma) from an operative series of 516 patients with Cushing's disease. To reach the adenoma transsphenoidally in these patients, the diaphragma sella was incised anteroposteriorly in the midline to the anterior edge of the stalk, the suprasellar cistern was entered, and the adenoma was selectively excised using care to limit injury to the infundibulum. After selective adenomectomy, Cushing's disease remitted in all patients. All patients were hypocortisolemic immediately after surgery and required hydrocortisone for up to 21 months. Apart from the adrenal axis, pituitary function was normal in five patients in the immediate postoperative period, including two patients with tumors confined to the stalk and three patients with preoperative hypothyroidism (one patient) and/or hypogonadism (three patients). Three others with transient postoperative hypothyroidism (one patient) or diabetes insipidus (two patients) had normal pituitary function within 7 months of surgery. One patient with hypothyroidism and one with hypogonadism before surgery had panhypopituitarism postoperatively. A patient with a microadenoma located high in the stalk next to the optic chiasm had bitemporal hemianopsia postoperatively. These results demonstrate the feasibility of achieving curative transsphenoidal resection and preservation of pituitary function in cases of pituitary adenomas that are confined to the pituitary stalk or tumors that extend superiorly within the stalk from an intrasellar origin.

Complete Microsurgical Resection of Large Retrochiasmatic Hypothalamic Craniopharyngioma by Transpetrosal Approach: 2-Dimensional Operative Video

2019 ◽  
Author(s):  
Qazi Zeeshan ◽  
Juan P Carrasco Hernandez ◽  
Nina T Yoh ◽  
Laligam N Sekhar
Keyword(s):  
Frozen Section ◽  
Brain Magnetic Resonance Imaging ◽  
Optic Chiasm ◽  
Pituitary Stalk ◽  
Excessive Sleepiness ◽  
Microsurgical Resection ◽  
Magnetic Resonance Imaging Mri ◽  
Prefixed Chiasm ◽  
The Right ◽  
Retrochiasmatic Region

Abstract This two-dimensional video shows the technical nuances of complete microsurgical resection of a hypothalamic craniopharyngioma located in the retrochiasmatic region by the transpetrosal approach.  This 49-yr-old man presented with progressive fatigue, excessive sleepiness, and difficulty in vision in both eyes. He was found to have right CN 3 paralysis and bitemporal hemianopsia on neurological examination. Further workup revealed panhypopituitarism. Brain magnetic resonance imaging (MRI) demonstrated a large solid retrochiasmatic hypothalamic lesion with homogeneous contrast enhancement, measuring 2.1 × 2.6 × 2.4 cm. Optic chiasm was prefixed, and the tumor was just posterior to the pituitary stalk area. The preoperative differential diagnosis included hypothalamic astrocytoma, craniopharyngioma, germinoma, and histiocytosis. Because of the prefixed chiasm, a presigmoid, transpetrosal approach was performed. Our initial plan was a large biopsy, but based on frozen section histology, we decided to excise the tumor completely. The tumor had a pseudocapsule, which was firm and yellowish. It was debulked, dissected from the surrounding hypothalamus, and removed completely. The pituitary stalk was found at the anterior and inferior ends of the tumor and was preserved.  Postoperatively, the patient developed diabetes insipidus and requires desmopressin replacement, which was gradually tapered. For panhypopituitarism, he is receiving thyroxine, hydrocortisone, and testosterone.  Postoperatively, patient had an improvement in vision in his left eye and ptosis was improving in the right eye with mRs 1- at 10-wk follow-up.  An informed consent was obtained from the patient prior to the surgery, which included videotaping of the procedure and its distribution for educational purposes. All relevant patient identifiers have also been removed from the video and accompanying radiology slides.

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