A series of 58 verified various sellar and parasellar lesions exclusive of aneurysms and inflammatory lesions was reviewed as to history, development and progression of the neurological features, spontaneous and steroid induced remission, endocrine disturbances, other laboratory findings, reontgenograms, differential diagnosis, operative methods and findings, and pathologic findings of the lesion.
The author has only emphasized some interesting points illustttated in our cases because other results do not differ greatly from previous authors reports.
1. No direct correlation was found to exist between the amount of the sellar destruction and the occurrence of endocrine disturbances. However, it was likely that marked endocrine changes were due to cystic formation in pituitary adenomas.
2. On angiograms of sellar and parasellar lesions, opening of the siphon and lateral displacement of the supraclinoid portion of the internal carotid artery were important in the diagnosis, and the event of nonvisualization of the posterior communicating and posterior cerebral arteries was observed in the majority of pituitary tumors.
3. In pituitary cystic adenomas, intracapsular bleeding was very hard to control on occasions because of rupturing vascular, network or trabeculae in the cyst.
4. Definition of the empty sella was always obscure in intracranial exploration under the diagnosis of pituitary tumor when no definite lesion was found.
5. In a hydrocephalic patient with raised intracranial pressure and a markedly enlarged third ventricle extending into the sella turcica, third ventriculostomy still seems to be the choice of treatment.
|