Case Challenge

Head and Neck

Neuro

Sella

Stephen J Pomeranz

Gain confidence interpreting Sella MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Neuroradiology

Case 1 - 76-year-old male presents with hemianopia and mass

Case 2 - 43-year-old female presents history of pituitary microprolactinoma

Case 3 - 21-year-old male presents with visual field defect

Case 4 - 42-year-old male presents with moderate to severe headaches

Case 5 - 53-year-old female presents with Rathke's cleft cyst

Case 6 - 46-year-old female presents with papilledema

Case 7 - 78-year-old female presents with headaches and pituitary lesion

Case 8 - 64-year-old female presents with severe intermittent left-sided headaches

Case 9 - 61-year-old male presents with hypogonadism

Case 10 - 9-year-old female presents with intractable headaches

Case 11 - 63-year-old female presents with right retroorbital pain, paresthesia

Case 12 - 67-year-old female presents with enlarged sella with intermittent anosmia

Case 13 - 13-year-old male presents with blurred vision

Case 14 - 63-year-old male presents with dizziness for four weeks

Case 15 - 46-year-old female presents with papilledema

Case 16 - 40-year-old female presents with history of left lower quadrant visual loss

Case 17 - 48-year-old female presents with headache

Case 18 - 54-year-old male presents with pituitary cyst

Case 19 - 35-year-old male presents with mild to moderate dizziness

Case 20 - 38-year-old male presents with pituitary macroadenoma

Case 21 - 33-year-old male presents with headaches

Case 22 - 56-year-old male presents with possible stroke

Case 23 - 61-year-old female presents with memory loss

Case 24 - 63-year-old male presents with benign neoplasm of pituitary gland

Case 25 - 31-year-old male presents with papilledema

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Sella MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Sella MRI Cases

<div>HISTORY:&#160;This 78-year-old female presents with headaches and pituitary lesion.(QUIZ ANSWER) EMPTY SELLA HAS BEEN ASSOCIATED WITH INTRACRANIAL HYPERTENSION:&#160;True.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:&#160;Intra-ocular lens implants.Venous sinuses are patent.No Chiari malformation.Empty sella.No abnormal meningeal enhancement.No enhancing mass within the internal auditory canals.No enlargement of the extraocular muscles.No chiasmal compression.Maxillary and ethmoid sinus mucosal thickening.No siderosis.Carotid and basilar artery flow voids are intact.Cerebral hemispheres and deep nuclei without hemorrhage, mass or edema.Periventricular white matter hyperintensities may represent gliosis of microangiopathic origin.No extra-axial hemorrhage.No transependymal spread of CSF or sulcal effacement.Diffusion-weighted images are without a diffusion-restrictive defect.No siderosis on gradient-echo images.Parietotemporal greater than frontal pattern of cerebral atrophy with relative preservation of hippocampal volume.Mild optic nerve sheath dilatation.CONCLUSION:1. No intracranial hemorrhage, neoplasm or obstructive hydrocephalus.2. CSF hyperintensity within the sella most likely represent empty sella.&#160;Differential could include the Rathke's cyst craniopharyngioma which may be less likely.&#160;Endocrine function testing may be considered to provide further definition if clinically relevant.3. Empty sella and optic nerve sheath dilatation have been associated with intracranial hypertension.&#160;Although patient demographic is atypical, eye examination to exclude papilledema is recommended in the setting of headaches.4. Venous sinuses are patent.5. No Chiari malformation.6. No supportive findings of basilar inflammatory process.7. Periventricular and white matter hyperintensities may represent gliosis of microangiopathic origin.&#160;No supportive findings of acute ischemia on diffusion-weighted images.&#160;Additional differential appropriate in the appropriate clinical setting could include vasculitis antiphospholipid antibody syndrome.</div>

Case

Empty sella and optic nerve sheath dilatation have been associated with intracranial hypertension.