Fractures of the sella turcica

Five recent cases of sella turcica fracture examined at the Medical Center Hospital of Vermont are reported. These fractures are most commonly associated with frontal or maxillofacial trauma and are complicated by cranial nerve palsies, chiasmatic injury, and cerebrospinal fluid rhinorrhea and otorrhea. The mortality rate with these fractures is high because of the associated brain injury. The importance of a detailed endocrine evaluation to detect developing pituitary abnormalities is also emphasized. The accuracy of radiographic diagnosis of these fractures utilizing plain skull films, tomography, and computed axial tomography is reviewed. the importance of cerebral angiography to evaluate the intracavernous internal carotid arteries and the basilar artery is also emphasized, as is the theoretical basis of the pathological findings associated with these fractures.