Lesions of the sella and suprasellar space

Abstract

The suprasellar cistern is limited below by the hypophysis, dorsum sellae and cavernous sinus, and above by the floor of the third ventricle. It is bounded anteriorly by the sphenoid jugum and clinoids, on each side by the medial temporal lobes, and posteriorly by the cerebral peduncles, at which point the suprasellar, ambient and prepontine cisterns are continuous. Its principal contents include the infundibulum, optic nerves and chiasm, the internal carotid-circle vessels, and arachnoid tissue. Usually, the space is referred to as suprasellar by neurosurgeons, and para-or juxtasellar by radiologists. Most texts give a list of lesions which can occur in this region^1,2, but for practical purposes the large majority of masses originate from the floor, mainly pituitary adenoma or craniopharyngioma, or a related cyst. Lesions from other structures, such as optic nerve and hypothalamic glioma, infundibular and vascular masses, are rare, and although granulomatous inflammation regularly affects the leptomeninges at this site, isolated inflammatory and parasitic masses are also very uncommon.