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Does pseudotumor cerebri cause the empty sella syndrome?

Neuropsychiatric Service, Memorial Sloan-Kettering Cancer Center, and the Department of Neurology, Cornell University Medical College, New York City.

Eight patients had both the "primary empty sella syndrome," diagnosed by the finding of an air-filled sella turcica at pneumoencephalography, and pseudotumor cerebri, diagnosed by the finding of an elevated cerebrospinal fluid pressure in the presence of normal ventricular size and position on pneumoencephalography. All eight patients were obese women, and six were hypertensive. Six complained of headaches and menstrual irregularities, and two were asymptomatic. Three had visual symptoms and four had papilledema at the time of examination. These two clinical disorders appear to be frequently related, and when they are related, visual field defects and visual loss are more likely to occur than when either entity appears alone. Chronically increased intracranial pressure from pseudotumor cerebri may produce an empty sella if the diaphragma sella is incompetent and the subarachnoid space herniates into the sella turcica.

Presented at the twenty-sixth annual meeting of the American Academy of Neurology, San Francisco, April 1974.

Received for publication November 18. 1974.

Dr. Posner's address is Neuropsychiatric Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021.

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