The Change of Sella Turcica in Hydrocephalus.

Park, Kyung Soo; Kim, Jong Hyun; Cho, Maeng Ki; Chae, Jin; Choi, Kil Soo; Sim, Bo Sung

Original Article

Journal of Korean Neurosurgical Society 1973;2(2): 57-64.

Kyung Soo Park, Jong Hyun Kim, Maeng Ki Cho, Jin Chae, Kil Soo Choi, Bo Sung Sim

Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.

ABSTRACT

In the past many authors have contributed most of the fundamental observations of alteration in the sella turcica resulting from raised intracranial pressure and hydrocephalus, and some authors have attempted to distinguish different types of sella change specific to particular pathology. The author has observed upon the change of sella with proved hydrocephalus in 57 patients(45 cases of obstructive hydrocephalus and 12 cases of communicating hydrocephalus) during the period from Jan. 1967 to July 1973 at the Department of Neurosurgery, Seoul National University Hospital. Results are as follows: 1. Among 57 cases in total; no evident abnormalities were seen in 18 cases(32%); erosion and circular expansion at the posterior portion of sella turcica in 36 cases(63%); erosion of the posterior clinoid processes in 31 cases(53%). These changes were more often observed in the cases over 15 years of age than under 15 years of age as well as in the cases of obstructive hydrocephalus than communicating one. 2. The changes of sella related to the site of lesion in obstructive hydrocephalus were as follows; radiologically normal sella were more often observed in the 3rd ventricular lesion than posterior fossa lesion, erosion and circular expansion of the posterior portion of sella in the posterior fossa lesion, and thinning and pointing of dorsum sella in the 3rd ventricular lesion. These changes of sella were not relevant to the age. 3. The changes of sella related to the duration of symptoms of raised intracranial pressure in the obstructive pattern were that the severity of changes was relatively proportionate to the duration; most of the changes were observed around the 6 months of duration regardless of the age. 4. The evident sellar enlargement was observed in 19 out of 36 cases with erosion and circular expansion of the posterior portion of sella, and sellar elongation in 4 cases. 5. Among 27 cases of the obstructive pattern being studied by ventriculogram, cases with anterior end of 3rd ventricle apart from the dorsum showed sellar changes in 40%, those touching the dorsum in 58%, and those extending into sella in 100%. The main findings in the latter two groups were the erosion and circular expansion of the posterior portion of the sella turcica. 6. The raised intracranial pressure did not produce the sellar changes without the change of vault in those cases below 15 years of age.