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Ronald Brisman, James E. O. Hughes and Lester A. Mount

-sided in two and left-sided in two. The side of the leak proved helpful in localizing the side of the fistula in the three cases in which this was possible. In the fourth patient a left-sided leak was associated with a bilaterally empty sella, and there was no x-ray or surgical evidence of lateralization of the fistula. None of these patients had elevated intracranial pressure or headache. Modification of this profile is provided by Ommaya's case of a 57-year-old man with a partially empty sella, mild hypopituitarism, seizures, and non-traumatic rhinorrhea. 16 There

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James N. Domingue, S. Douglas Wing and Charles B. Wilson

E xtension of the subarachnoid space into the sella turcica, or the empty sella syndrome, has been described in detail. However, only a few patients with pituitary adenomas and coexisting partially empty sellas have been reported. To date this association has been seen in acromegaly, 16, 21, 23 in patients with the Forbes-Albright syndrome (amenorrhea, galactorrhea, pituitary tumor), 21 and recently in a patient with Cushing's syndrome. 8 This paper reports our series of 17 patients with coexisting pituitary adenomas and partially empty sellas discovered

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1978 48 1 13 22 10.3171/jns.1978.48.1.0013 Coexisting pituitary adenomas and partially empty sellas James N. Domingue S. Douglas Wing Charles B. Wilson January 1978 48 1 23 28 10.3171/jns.1978.48.1.0023 Survival status of children with cerebellar gliomas Alan Leviton Anita Fulchiero Floyd H. Gilles Ken Winston January 1978 48 1 29 33 10.3171/jns.1978.48.1.0029 The dilemma of childhood optic gliomas Donald C. Oxenhandler Martin P. Sayers January 1978 48 1 34 41 10.3171/jns.1978.48.1.0034 SEM evaluation of endothelial damage following temporary

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Charles B. Wilson and Lawrence C. Dempsey

angiography and pneumoencephalography. A few patients were referred with a current pneumoencephalogram in hand; some studies were of acceptable quality, others were repeated. Precise delineation of a tumor's superior surface is essential in virtually every case. Of comparable importance is the pattern of intrasellar air when a tumor is associated with a partially empty sella turcica; this is often, but not always, seen after prior treatment. The preceding requirements are satisfied by multiple biplane polytomographic cuts at 2-mm intervals. Bilateral carotid angiograms

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Dwight C. Evans, Martin G. Netsky, Verne E. Allen and Vira Kasantikul

, Wilson CB : Coexisting pituitary adenomas and partially empty sellas. J Neurosurg 48 : 23 – 28 , 1978 Domingue JN, Wing SD, Wilson CB: Coexisting pituitary adenomas and partially empty sellas. J Neurosurg 48: 23–28, 1978 10. du Boulay GH , El Gammal T : The classification, clinical value and mechanism of sella turcica changes in raised intracranial pressure. Br J Radiol 39 : 422 – 442 , 1966 du Boulay GH, El Gammal T: The classification, clinical value and mechanism of sella turcica changes in raised

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Philip H. Gutin, William G. Cushard Jr. and Charles B. Wilson

P ituitary apoplexy has led to regression of Cushing's disease in one previously reported case and to spontaneous fracture of the dorsum sellae in another. 11 A pituitary tumor secreting adrenocorticotropic hormone (ACTH) and located in a partially empty sella has, likewise, been reported only once previously. 8 The patient reported here combined these rare phenomena. She had an ACTH-secreting pituitary tumor that became inactive after apoplexy. A recurrent tumor was later detected and removed from a partially empty sella with a fractured dorsum. Case

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Isabelle L. Richmond, Thomas H. Newton and Charles B. Wilson

EMI 5005, and a GE 7800), it was not possible to evaluate reliably the presence of intrasellar adenomas, partially empty sellas, or minimal suprasellar extension. For this reason, CT was not used in the preoperative evaluation of most of these patients. Angiography is reserved for those patients with hyperprolactinemia who have gross expansion of the sella, or suprasellar extension. It is also used 1) to exclude the possibility of an aneurysm in patients in whom a pituitary tumor is suspected but hormonal hypersecretion cannot be documented, and 2) to evaluate the

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Symptomatic Rathke's cleft cysts

Report of two cases

Gary K. Steinberg, George H. Koenig and James B. Golden

; an isotope brain scan was normal. Repeat arteriogram and a PEG demonstrated increasing dilatation of the lateral and third ventricles compared with previous studies, and a normal-sized fourth ventricle. The sella was enlarged and contained a mass, but there was no evidence of suprasellar extension. Air in the anterior sella suggested a partially empty sella, thought possibly to be secondary to increased intracranial pressure ( Fig. 1 ). A ventriculogram revealed delayed egress of contrast material through the cerebral aqueduct and at the outflow of the fourth

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James E. Boggan, J. Blake Tyrrell and Charles B. Wilson

. The latter was the primary preoperative radiological study. Metrizamide cisternography with CT was used, when indicated, to evaluate unusual suprasellar and parasellar extension and to help differentiate a low-density adenoma from a partially empty sella. Carotid angiography proved to be generally uninformative and was deleted from the preoperative evaluation, as was pneumoencephalography when high-resolution CT scanning became available. Abdominal ultrasonography, iodocholesterol scanning, CT of the adrenal glands, and adrenal arteriography were used selectively

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A decade of pituitary microsurgery

The Herbert Olivecrona Lecture

Charles B. Wilson

, is clinically silent. 26 Spontaneous resolution of the appropriate hypersecretion syndrome and a partially empty sella (that is, an enlarged sella containing an adenoma with intrasellar extension of CSF) 22 are clinical manifestations of tumor necrosis. Operative Approaches to Pituitary Adenomas The operative approaches to pituitary adenomas have been described in detail elsewhere. 58 The tumor's configuration determines the choice between the transcranial and the transsphenoidal approaches. The transsphenoidal approach is the technique of choice for