Idiopathic intracranial hypertension
Chronic headache for routine MRI study. No visual or hormonal disturbances.
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The sella is enlarged and completely occupied by cerebrospinal fluid. The remnant of the pituitary gland is compressed against the sellar wall.
The infundibulum traverses the enlarged sella to reach its floor where residual pituitary tissue is present.
There is prominence of the subarachnoid space around the optic nerves on T2.
The supra and infratentorial brain compartments do not demonstrate abnormal signal intensity or contrast enhancement.
Prominence of subarachnoid space around the optic nerves alongside sella turcica enlargement due to cerebrospinal fluid accumulation with a traversing pituitary infundibulum (features indicative of empty sella) are imaging findings supportive of idiopathic intracranial hypertension in middle-aged obese females after excluding other causes of raised intracranial pressure (ICP).
Although often incidental, the “empty” sella turcica can reflect chronically elevated ICP. It is particularly common in the setting of idiopathic intracranial hypertension (IIH).
- 1. Amit M. Saindane, Paolo P. Lim, Ashley Aiken, Zhengjia Chen, Patricia A. Hudgins. Factors Determining the Clinical Significance of an “Empty” Sella Turcica. (2013) American Journal of Roentgenology. 200 (5): 1125-31. doi:10.2214/AJR.12.9013 - Pubmed
- 2. VM Haughton, AE Rosenbaum, AL Williams, B Drayer. Recognizing the empty sella by CT: the infundibulum sign. (2012) American Journal of Roentgenology. 136 (2): 293-5. doi:10.2214/ajr.136.2.293 - Pubmed