scholarly journals Enlargement of the sella turcica in pseudotumor cerebri

2014 ◽  
Vol 120 (2) ◽  
pp. 538-542 ◽  
Author(s):  
Sung-eun E. Kyung ◽  
James V. Botelho ◽  
Jonathan C. Horton
Keyword(s):  
Intracranial Pressure ◽  
Pituitary Gland ◽  
Sella Turcica ◽  
Pseudotumor Cerebri ◽  
Empty Sella ◽  
Slight Reduction ◽  
Mr Images ◽  
Pituitary Fossa ◽  
Cross Sectional ◽  
Bony Enlargement

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.

scholarly journals Empty Sella Prevalence: Step By Step

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Victoria B. Sharavii ◽  
Natalya A. Shnayder ◽  
Lada K. Sharavii ◽  
Marina M. Petrova ◽  
Regina F. Nasyrova
Keyword(s):  
Pituitary Gland ◽  
Subarachnoid Space ◽  
Sella Turcica ◽  
Empty Sella ◽  
Systematic Search ◽  
Pituitary Fossa ◽  
The World

An empty sella (ES), also known as an empty sella turcica (empty pituitary fossa) is defined as an intrasellar herniation of subarachnoid space within the sella which leads to flattening of the pituitary gland towards the posteroinferior wall. Purpose — to analyze studies of ES prevalence in the world. Methods — We carried out a systematic search in both Russian and English databases (E-library, PubMed, GoogleScholar, OxfordPress, ClinicalKeys) using keywords “empty sella”, “empty sella turcica”, “empty pituitary fossa”, “prevalence” and their combinations. The period of search: 2000-2020. It is also worth noting that earlier publications of historical interest were included in the review. Results — We have analyzed 23 studies. They can be roughly devided into two groups: the first group – screening studies of ES, the second group – targeted studies of ES.

CORTICOSTERONE SECRETING ADRENAL CARCINOMA AND EMPTY SELLA TURCICA: A CASE REPORT

1979 ◽  
Vol 91 (4) ◽  
pp. 650-656
Author(s):  
Bjørn Krølner ◽  
Steen Larsen ◽  
Meta Damkjær Nielsen
Keyword(s):  
Sella Turcica ◽  
Pituitary Hormones ◽  
Empty Sella ◽  
High Dose ◽  
Adrenal Carcinoma ◽  
Pituitary Fossa ◽  
High Dose Dexamethasone ◽  
Corticosterone Metabolites ◽  
Steroid Excretion ◽  
Urinary Steroid

ABSTRACT Pituitary adenoma was suspected in a woman of 74 with hypercorticism, hypokalaemic alkalosis and radiographically enlarged sella turcica. However, non-suppressibility of steroid excretion by high-dose dexamethasone and low plasma concentration of ACTH suggested adrenal tumour. Detailed analysis of urinary steroid excretions demonstrated unusually large amounts of corticosterone metabolites, 14.6 mg/24 h compared to a mean normal value of 0.5 mg. The basal levels of the remaining pituitary hormones were unremarkable. The patient died incidentally before a planned adrenalectomy. The autopsy disclosed an adrenal carcinoma and an empty sella turcica. The enlarged pituitary fossa was lined by a narrow rim of histological normal pituitary tissue.

scholarly journals The Pituitary Gland Measurements in Sudanese Females using Magnetic Resonance Imaging

2020 ◽  
Vol 10 (4) ◽  
pp. 397-401
Author(s):  
Shayma Hamed ◽  
Ayad CE ◽  
Rana Eisa ◽  
Awadia Gareeballah ◽  
Alaa Ibrahim ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Medical Center ◽  
Brain Mri ◽  
Age Groups ◽  
Sella Turcica ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Adult Females ◽  
The Mean ◽  
Brain Examination

Background: Assessment of the pituitary gland (PG) measurements is essential for the diagnosis of many pathological conditions. For Sudanese adult females, however, there have been no studies and no reference values for PG measurements. Therefore, the aim of this study was to determine the regular dimensions of the PG, using MRI, and to correlate these measurements with age, the shape of sella turcica, puberty age, and parity in Sudanese females. Methods and Results: This cross-sectional study was done to assess the PG measurement in Sudanese adult females (n=63) aged between 20 years and 60 years who underwent a brain MRI examination between 2015 and 2019. The study was conducted at Yastabshiroon Umodorman Medical Center (Khartoum, Sudan). The MRI brain examination found that the mean length, depth, width, and volume of the PG were 10.57±1.27 mm, 5.56±1.42 mm, 12.18±1.67 mm, and 356.38±100.22 mm3, respectively. Concerning the shape of the sella turcica, the study revealed that the convex and concave shape were more frequent than others (39.7% and 34.9%, respectively). The depth, width, length, and volume of the gland had changed significantly with pituitary shapes. The PG depth was significantly higher in nulliparous females than multiparous ones. Conclusion: The PG measurement in adult Sudanese females decreased in the sagittal depth and volume gradually till the age of 50 years then returned to increasing after age 50. Younger females in the age group of 20-30 years had a larger depth and volume of the gland than other age groups.

AYURVEDIC MANAGEMENT OF PARTIAL EMPTY SELLA SYNDROME: A CASE REPORT

2021 ◽  
Vol 12 (4) ◽  
pp. 15-18
Author(s):  
Eswara M P Sarma ◽  
Arathi P K
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Pituitary Gland ◽  
Sella Turcica ◽  
Marked Change ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Lukewarm Water

Empty Sella Syndrome is a disorder that involves the presence of Cerebro-spinal fluid in Sella turcica in an excess amount. In empty Sella syndrome the Sella turcica is either partially filled with cerebrospinal fluid and an atrophied pituitary gland lying in the floor of the Sella (Partial Empty Sella Syndrome) or filled with cerebrospinal fluid which pushes the pituitary gland into a side of Sella turcica resulting in non-visualization of the gland. (Completely empty Sella). A 37-year-old female diagnosed with partial empty Sella syndrome was managed with Pathyakshadhatryadi kashayam 15 ml twice daily in empty stomach with 45 ml lukewarm water, Rasnadi choornam tailam application, mahatraiphala ghritam 10 ml at night after food, Kshirabala 7 Avarti tailam pratimarsha nasyam. After completion of the treatment, there was considerable relief in the primary complaint of the patient which was a recurrent headache and the follow up MRI showed a marked change in the condition. This case report highlights the role of Ayurveda in the management of partial empty Sella syndrome and sheds light for further study on the same.

Reconstruction of the Pituitary Fossa in Transsphenoidal Surgery: An Experience of 140 Cases

Neurosurgery ◽  
1985 ◽  
Vol 17 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Renato Spaziante ◽  
Enrico de Divitiis ◽  
Paolo Cappabianca
Keyword(s):  
Cerebrospinal Fluid ◽  
Transsphenoidal Surgery ◽  
Sella Turcica ◽  
Empty Sella ◽  
Transsphenoidal Approach ◽  
Cerebrospinal Fluid Leakage ◽  
Pituitary Fossa ◽  
Postoperative Course ◽  
Precise Method ◽  
Surgical Condition

Abstract Even though the main problems of transsphenoidal surgery are encountered during the intra- and suprasellar portions of the operation, proper reconstruction of the sella turcica plays an important role in the overall results, greatly influencing the final outcome. Improper measures may bring about a complicated postoperative course, whereas a wise and precise method allows one to control any surgical condition, preventing the more dangerous consequences of the transsphenoidal approach (i.e., empty sella, cerebrospinal fluid leakage, hemorrhage, infection, etc.). The authors review the different methods of sellar plugging and, on the basis of their own experience, indicate the most suitable one for each of the more usual situations. A good result is achievable if only natural materials are used and one avoids synthetic prostheses. Extradural packing is the technique of choice whenever a hermetic closure and a particularly effective intrasellar plug are required.

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Nian Chen ◽  
Zhenhua Hong ◽  
Yongyu Zheng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Ventral Side ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions. Methods A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7 ± 8.7 vs 68.4 ± 10.5, P < 0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P < 0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P < 0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

Seven-year trends in the availability, sugar content and serve size of single-serve non-alcoholic beverages in New Zealand: 2013–2019

2020 ◽  
pp. 1-13
Author(s):  
Teresa Gontijo de Castro ◽  
Helen Eyles ◽  
Cliona Ni Mhurchu ◽  
Leanne Young ◽  
Sally Mackay
Keyword(s):  
New Zealand ◽  
Sugar Content ◽  
Food Composition ◽  
Soft Drinks ◽  
Alcoholic Beverages ◽  
Slight Reduction ◽  
Cross Sectional ◽  
Sweetened Beverages ◽  
Sugary Drinks ◽  
High Sugar Content

Abstract Objective: To assess trends in relative availability, sugar content and serve size of ready-to-drink non-alcoholic beverages available for sale in supermarkets from 2013 to 2019. Design: Repeat cross-sectional surveys. Data on single-serve beverages to be consumed in one sitting were obtained from an updated brand-specific food composition database. Trends in beverages availability and proportions with serve size ≤ 250 ml were assessed by χ2 tests. Sugar content trends were examined using linear regressions. The proportion of beverages exceeding the sugar threshold of the United Kingdom Soft Drinks Industry Levy (SDIL) was assessed. Setting: New Zealand. Results: From 2013 to 2019, there was (i) an increase in the availability of sugar-free/low-sugar beverages (n 25 (8·4 %) to n 75 (19·1 %); P < 0·001) and craft sugar-sweetened soft drinks (n 11 (3·7 %) to n 36 (9·2 %); P < 0·001), and a decrease in availability of fruit/vegetable juices/drinks (n 94 (31·8 %) to n 75 (19·4 %); P < 0·001); (ii) small decreases in sugar content (mean g/100 ml) of sugar-sweetened soft drinks (3·03; 95 % CI 3·77, 2·29); fruit/vegetable juices/drinks (1·08; 95 % CI 2·14, 0·01) and energy drinks (0·98; 95 % CI 1·63, 0·32) and (iii) slight reduction in the proportion of beverages with serve size ≤ 250 ml (21·6 to 18·9 %; P < 0·001). In 2019, most beverages were sugar-sweetened or had naturally occurring sugars (79·1 %) and serve size > 250 ml (81·1 %) and most sugar-sweetened beverages exceeded the SDIL lower benchmark (72·9 %). Conclusions: Most single-serve beverages available for sale in 2019 were sugary drinks with high sugar content and large serve sizes; therefore, changes made across the years were not meaningful for population’s health.

scholarly journals Migraine or idiopathic intracranial hypertension: Magnetic resonance venography and magnetic resonance imaging findings

2020 ◽  
Vol 33 (3) ◽  
pp. 244-251
Author(s):  
Aynur Guliyeva ◽  
Melda Apaydin ◽  
Yesim Beckmann ◽  
Gulten Sezgin ◽  
Fazil Gelal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Intracranial Pressure ◽  
Pituitary Gland ◽  
Optic Nerve Sheath ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Chi Square ◽  
Nerve Sheath

Background Idiopathic intracranial hypertension (IIH) is a disease characterised by increased cerebral pressure without a mass or hydrocephalus. We aimed to differentiate migraine and IIH patients based on imaging findings. Results Patients with IIH ( n = 32), migraine patients ( n = 34) and control subjects ( n = 33) were evaluated. Routine magnetic resonance imaging, contrast-enhanced 3D magnetic resonance venography and/or T1-weighted 3D gradient-recalled echo were taken with a 1.5 T magnetic resonance scanner. Optic-nerve sheath distention, flattened posterior globe and the height of the pituitary gland were evaluated in the three groups. Transverse sinuses (TS) were evaluated with respect to score of attenuation/stenosis and distribution. Pearson chi-square, Fisher’s exact test and chi-square trend statistical analyses were used for comparisons between the groups. A p-value of <0.05 was considered statistically significant. Decreased pituitary gland height, optic-nerve sheath distention and flattened posterior globe were found to be statistically significant ( p < 0.001) in IIH patients. Bilateral TS stenosis was also more common in IIH patients than in the control group and migraine group ( p = 0.02). Conclusion Decreased pituitary gland height, optic-nerve sheath distention, flattened posterior globe, bilateral stenosis and discontinuity in TS are significant findings in differentiating IIH cases from healthy individuals and migraine patients. Bilateral TS stenosis may be the cause rather than the result of increased intracranial pressure. The increase in intracranial pressure, which is considered to be responsible for the pathophysiology of IIH, is not involved in the pathophysiology of migraine.

Verbal memory deficits associated with fornix atrophy in carbon monoxide poisoning

2001 ◽  
Vol 7 (5) ◽  
pp. 640-646 ◽  
Author(s):  
SHELLI R. KESLER ◽  
RAMONA O. HOPKINS ◽  
LINDELL K. WEAVER ◽  
DUANE D. BLATTER ◽  
HOLLY EDGE-BOOTH ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Verbal Memory ◽  
Visual Memory ◽  
Carbon Monoxide Poisoning ◽  
Neuropsychological Testing ◽  
Mr Images ◽  
Cross Sectional ◽  
Memory Processing ◽  
Within Subjects ◽  
And Gender

Magnetic resonance (MR) images and neuropsychological testing data of 69 carbon monoxide (CO) poisoned patients were prospectively obtained within 1 day of CO poisoning, two weeks and six months. CO patients' Day 1 cross-sectional fornix surface area measurements, corrected for head size by using a fornix-to-brain ratio (FBR), were compared to normal age and gender-matched controls. Additionally, a within-subjects analysis was performed comparing the mean areas between CO patients' Day 1, 2 weeks and 6-month FBR. The FBR was correlated with patients' neuropsychological data. There were no significant differences between CO patients' Day 1 fornix measurements compared to normal control subjects. However, significant atrophic changes in the fornix of CO poisoned patients occurred at two weeks with no progressive atrophy at 6 months. By 6 months, CO patients showed significant decline on tests of verbal memory (when practice effects were taken into account), whereas visual memory, processing speed and attention/concentration did not decline. This study indicates that CO results in brain damage and cognitive impairments in the absence of lesions and other neuroanatomic markers. (JINS, 2001, 7, 640–646.)

The Medial Wall of the Cavernous Sinus: Microsurgical Anatomy

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 179-190 ◽  
Author(s):  
Alexandre Yasuda ◽  
Alvaro Campero ◽  
Carolina Martins ◽  
Albert L. Rhoton ◽  
Guilherme C. Ribas
Keyword(s):  
Pituitary Gland ◽  
Cavernous Sinus ◽  
Thin Sheet ◽  
Single Layer ◽  
Lateral Wall ◽  
The Body ◽  
Medial Wall ◽  
Microsurgical Anatomy ◽  
Pituitary Fossa ◽  
Adjacent Structures

Abstract OBJECTIVE: This study was conducted to clarify the boundaries, relationships, and components of the medial wall of the cavernous sinus (CS). METHODS: Forty CSs, examined under ×3 to ×40 magnification, were dissected from lateral to medial in a stepwise fashion to expose the medial wall. Four CSs were dissected starting from the midline to lateral. RESULTS: The medial wall of the CS has two parts: sellar and sphenoidal. The sellar part is a thin sheet that separates the pituitary fossa from the venous spaces in the CS. This part, although thin, provided a barrier without perforations or defects in all cadaveric specimens studied. The sphenoidal part is formed by the dura lining the carotid sulcus on the body of the sphenoid bone. In all of the cadaveric specimens, the medial wall seemed to be formed by a single layer of dura that could not be separated easily into two layers as could the lateral wall. The intracavernous carotid was determined to be in direct contact with the pituitary gland, being separated from it by only the thin sellar part of the medial wall in 52.5% of cases. In 39 of 40 CSs, the venous plexus and spaces in the CS extended into the narrow space between the intracavernous carotid and the dura lining the carotid sulcus, which forms the sphenoidal part of the medial wall. The lateral surface of the pituitary gland was divided axially into superior, middle and inferior thirds. The intracavernous carotid coursed lateral to some part of all the superior, middle, and inferior thirds in 27.5% of the CSs, along the inferior and middle thirds in 32.5%, along only the inferior third in 35%, and below the level of the gland and sellar floor in 5%. In 18 of the 40 CSs, the pituitary gland displaced the sellar part of the medial wall laterally and rested against the intracavernous carotid, and in 6 there was a tongue-like lateral protrusion of the gland that extended around a portion of the wall of the intracavernous carotid. No defects were observed in the sellar part of the medial wall, even in the presence of these protrusions. CONCLUSION: The CS has an identifiable medial wall that separates the CS from the sella and capsule of the pituitary gland. The medial wall has two segments, sellar and sphenoidal, and is formed by just one layer of dura that cannot be separated into two layers as can the lateral wall of the CS. In this study, the relationships between the medial wall and adjacent structures demonstrated a marked variability.

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