Aracnoidocele intrasillar. Clasificación

Authors: Dr. Bernardo Boleaga Durán1; Eduardo Guzmán Nuquez 2

1 Del CT Scanner de México
2 Del Departamento de Radiología e Imagen de la Unidad Médica Urdesa. Guayaquil, Ecuador. Puebla No. 228, Col. Roma, 06700, México, D.F.
Copias (copies): Dr. Bernardo Boleaga-Durán
E-mail: bernardoboleaga@prodigy.net.mx


Introduction:

In Computed Tomography and Magnetic Resonance Imaging of the skull studies, is often to incidentally note intrasellar extension of the subarachnoid space into the cavity of the sella turcica, which is regarded as an anatomical variation in most cases. In some patients, this finding is associated with dizziness, vertigo, headache, visual disturbances, brain spinal fluid fistula and hormonal disorders.


Objective:

In this paper we propose a simple methodology to assess the four grades of severity intrasellar arachnoidocele, known generically as an empty sella syndrome.

Material and methods: From May 1988 through December 2007 were done 12,030 studies of the skull using a GE® MR-Max 0.5 T, a Siemens® Avant 1.5 T, and a GE® Signa 1.5 T. It was observed the appearance and content of the sella turcica, identifying in four degrees (25%, 50%, 75% and 100%) the extension of the subarachnoid space to the cavity block.


Results:

Of all the cases studied (n = 12,030) was detected intrasellar arachnoidocele in 7.5% (n = 902). Grade IV showed the highest frequency, with predominance in females (70%).


Discussion:

Historically, the air used as the contrast medium into the ventricular system or subarachnoid space, could be seen with free passage to the cavity of the sella turcica. When it was a part or all of the cavity block, it was referred generically as &ldquoempty sella syndrome”. Using Magnetic Resonance Imaging and Computed Tomography can demonstrate with highest quality the intrasellar arachnoidocele. In some cases it is associated with headache, visual and endocrine disturbances. The classification proposed in this paper allows an easy evaluation of this finding.


Conclusion:

The proposed methodology allows the objectively evaluation of the severity of intrasellar arachnoidocele.