Medical Imaging of Normal and Pathologic Anatomy
Visit the link below to download the full version of this book:
https://medipdf.com/product/medical-imaging-of-normal-and-pathologic-anatomy/
Click Download Now
Contents
Foreword vii 43. Mediastinal lymphoma (CT) 43
Acknowledgments ix 44. Aneurysm of the ascending aorta
Introduction xi (radiograph/CT) 44
45. Situs inversus (radiograph) 45
46. Right aortic arch (radiograph) 46
Head and Neck 47. Coarctation of the aorta (CT) 47
48. Aberrant right subclavian artery (CT) 48
1. Hydrocephalus (MRI) 1 49. Coronary artery disease (CT) 49
2. Cephalhematoma (CT) 2 50. Aberrant right coronary artery (CT) 50
3. Metastatic brain tumors (MRI) 3 51. Coronary angioplasty (CT) 51
4. Primary brain tumor (MRI) 4 52. Aortic valve stenosis (CT) 52
5. Pituitary tumor (MRI) 5 53. Atrial septal defect (ostium secundum)
6. Pineal gland cyst (MRI) 6 (MRI) 53
7. Papilledema—pseudotumor cerebri (MRI) 7 54. Hypertrophic cardiomyopathy (MRI) 54
8. Vestibulocochlear nerve schwannoma (MRI) 8 55. Internal mammary (thoracic) artery
9. Acute epidural hematoma (CT) 9 coronary bypass (CT) 55
10. Acute subdural hematoma (CT) 10 56. Pleural effusion (1) (radiograph) 56
11. Chronic subdural hematoma (CT) 11 57. Pleural effusion (2) (CT) 57
12. Meningioma (MRI) 12 58. Emphysema (CT) 58
13. Ischemic stroke (CT) 13 59. Lung cancer (radiograph) 59
14. Internal carotid artery aneurysm (1) 60. Lung cancer, advanced (radiograph) 60
(angiogram) 14 61. Lung cancer, right upper lobe (CT) 61
15. Internal carotid artery aneurysm (2) (CT) 15 62. Large sliding hiatal hernia (radiograph) 62
16. Carotid bifurcation plaque (CT) 16 63. Small sliding hiatal hernia (radiograph) 63
17. Soft plaque, internal carotid artery (CT) 17 64. Esophageal varices (CT) 64
18. Maxillary and ethmoidal sinusitis (CT) 18 65. Diaphragmatic hernia (1) (radiograph) 65
19. Asymmetry of the frontal sinuses (CT) 19 66. Diaphragmatic hernia (2) (CT) 66
20. Blow-out fractures (CT) 20
21. Deviated nasal septum (CT) 21
22. Nasal bone fracture (CT) 22 Abdomen
23. Dislocation of the temporomandibular
joint articular disc (MRI) 23 67. Metastases (CT) 67
24. Degenerative joint disease, 68. Umbilical hernia (CT) 68
temporomandibular joint (TMJ) (CT) 24 69. Inguinal hernia (CT) 69
25. Parotid gland tumor (CT) 25 70. Caput medusae (CT) 70
26. Dilated submandibular duct, with 71. Ascites (CT) 71
calculus (CT) 26 72. Abdominal adenopathy (MRI) 72
27. Mandibular fracture (Panorex) 27 73. Abdominal aortic aneurysm (CT) 73
28. Basal skull fracture (CT) 28 74. Psoas abscess (CT) 74
29. Pharyngeal mass (CT) 29 75. Carcinoma of gastroesophageal
30. Tongue (lingual) cancer (MRI) 30 junction (CT) 75
31. Enlarged deep cervical lymph nodes (CT) 31 76. Duodenal ulcer (radiograph) 76
32. Thyroid nodule (US) 32 77. Ileal (Meckel’s) diverticulum (fluoroscopy) 77
33. Thyroglossal duct cyst (CT) 33 78. Hepatic cirrhosis (CT) 78
34. Goiter (enlarged thyroid gland) (US) 34 79. Splenomegaly (CT) 79
80. Renal cyst (simple) (CT) 80
81. Renal cyst (complex) (MRI) 81
Thorax 82. Urolithiasis, renal calculus (CT) 82
83. Renal carcinoma (US/CT) 83
35. Pectus carinatum (CT) 35 84. Adult polycystic kidney disease/
36. Pectus excavatum (CT/radiograph) 36 transplant (MRI) 84
37. Pneumothorax (radiograph) 37 85. Adenocarcinoma of the pancreas (CT) 85
38. Pneumonia (radiograph) 38 86. Malrotation of the small bowel (radiograph) 86
39. Pulmonary embolism (CT) 39 87. Obstructed common bile duct (US) 87
40. Breast cancer (mammogram) 40 88. Gallstones (US) 88
41. Breast cyst, breast cancer (US) 41 89. Volvulus (CT) 89
42. Mediastinal tumor (CT) 42 90. Appendicitis (CT) 90
Contents v
91. Inflammatory bowel disease, regional 125. Rotator cuff (supraspinatus) tear (MRI) 125
enteritis, Crohn’s disease (CT) 91 126. Superior labrum, anterior to posterior
92. Ulcerative colitis (CT) 92 (SLAP) tear (MRI) 126
93. Urolithiasis, ureteral calculi, and dilated 127. Enlarged axillary nodes (CT) 127
renal collection system (CT) 93 128. Dislocated biceps brachii tendon (MRI) 128
129. Olecranon fracture (radiograph) 129
130. Fracture of the radial head
Pelvis and Perineum (radiograph/CT) 130
131. Pronator teres muscle tear (MRI) 131
94. Benign prostatic hypertrophy (BPH) (CT) 94
132. Scaphoid fracture (MRI) 132
95. Uterine fibroids (Leiomyomas) (MRI) 95
133. Triangular fibrocartilage complex
96. Bicornuate uterus (MRI) 96
(TFCC; articular disc) tear (MRI) 133
97. Ovarian cyst (US) 97
134. Colles fracture (radiograph) 134
98. Ovarian dermoid cyst (teratoma)
135. Smith fracture (radiograph) 135
(CT/radiograph) 98
136. Boxer’s fracture (radiograph) 136
99. Urinary bladder diverticulum (CT) 99
100. Urolithiasis, bladder calculus (CT) 100
101. Varicocele (US) 101
102. Epididymitis (US) 102
Lower Limb
103. Epididymal cyst (US) 103 137. Posterior hip dislocation with fracture
104. Hydrocele (US) 104 of the acetabulum (CT) 137
105. Testicular tumor (US) 105 138. Metastatic tumor of acetabulum (CT) 138
106. Testicular torsion (US) 106 139. Fracture of the proximal femur
(radiograph) 139
140. Degenerative joint disease, hip
Back (radiograph) 140
107. Axis (C2) fracture (CT) 107 141. Avascular necrosis (AVN) of the femoral
108. Cervical intervertebral disc herniation head (MRI) 141
(MRI) 108 142. Iliopsoas bursitis (MRI) 142
109. Degenerative joint disease, cervical 143. Obstructed femoral artery (CT arteriogram) 143
facet joints (CT) 109 144. Deep venous thrombosis (US) 144
110. Vertebral body compression fracture (CT) 110 145. Knee joint effusion (MRI) 145
111. Fracture of the pars interarticularis (CT) 111 146. Medial (tibial) collateral ligament
112. Spondylolisthesis (secondary to pars (MCL) tear (MRI) 146
defect) (CT) 112 147. Medial meniscal tear (MRI) 147
113. Degenerative spondylolisthesis (1) (MRI) 113 148. Quadriceps tendon tear (MRI) 148
114. Degenerative spondylolisthesis (2) (MRI) 114 149. Patellar tendon tear (MRI) 149
115. Infectious discitis/vertebral osteomyelitis 150. Anterior cruciate ligament tear (MRI) 150
(CT) 115 151. Popliteal (Baker) cyst (MRI) 151
116. Variation in number of lumbar vertebrae 152. Degenerative joint disease, knee
(radiograph) 116 (radiograph) 152
117. Sacroiliitis (CT) 117 153. Tibial fracture (radiograph) 153
118. Herniated lumbar disc with neural 154. Pes anserinus bursitis (MRI) 154
compression (MRI) 118 155. Calcaneal tendon tear (MRI) 155
119. Lumbar spinal canal stenosis (MRI) 119 156. Calcaneal fracture (CT) 156
120. Complete transection of the spinal 157. Ankle fracture (radiograph) 157
cord (MRI) 120 158. Fracture of the medial malleolus and
distal fibula (radiograph) 158
159. Ankle sprain (MRI) 159
Upper Limb 160. Degenerative cystic changes,
sesamoid bone of hallux (CT) 160
121. Acromioclavicular joint separation 161. Plantar fasciitis (MRI) 161
(radiograph) 121
122. Anterior shoulder dislocation (AP view)
(radiograph) 122 Other
123. Anterior shoulder dislocation (“Y” view)
(radiograph) 123 162. Radionuclide bone scan (nuclear) 162
124. Fractured rim of glenoid fossa
Index 163
(CT reconstruction) 124
vi Contents
Foreword
I was already the proud father of three b eautiful and a well-developed editorial eye. And because
girls when my pregnant wife went in for an they are made by hand, they naturally take time to
ultrasound. She hadn’t felt any movement for a produce. And time of course is the one thing we
couple of days, and the doctor was concerned. no longer seem to have.
She remembers lying there in the dark in a polka Radiographs, CT scans, MR images and ultra-
dotted johnnie s taring nervously at the ceiling. sound scans are comparatively quick to produce,
At last the t echnician spoke to her, pointing to the but because they are machine made, these “pictures”
screen. make no attempt to go beyond simply presenting
“See that?” she said, moving a little arrow toward the information they capture. In fact, they are so
exhibit “A”–an amorphous pale blob attached to a foreign to our experience, at least at first, that they
larger amorphous pale blob in a snow storm. become the subject matter rather than the body
“It’s a penis.” they represent.
Our son came into the world screaming and It might be presumed by those of us outside
healthy a few months later blissfully unaware of the the medical profession that the mere existence of
intrusion into his privacy. these kinds of images will tell the experts what they
Our second encounter with medical imaging, need to know. But we would never assume that
in this case a good old x-ray, was produced about medical illustrators just somehow know what to do
two years later and also relates to our son. It when they sit down in front of a body even though,
documents in no uncertain terms the results of a like most of us, they’ve grown up with recogniz-
brief flight between the second from the bottom able images– drawings, paintings, photographs,
step and the floor. While we didn’t have a picture and videos– often with familiar landmarks, a tree, a
of an intact clavicle for comparison, the break in person, not to mention easily distinguishable solids
the elegant curvature, combined with the scream and shadows.
each time we lifted him, left little doubt as to the This more recent medical imagery, however,
problem. does not benefit from the same familiarity. By
At six years old, that same boy experienced the their very nature, these are pictures of things we
thumping and banging pleasures of an MR imaging don’t see while growing up, at least on a regular
machine as we attempted to precisely locate a splin- basis, and for that reason they remain ambiguous
ter that had virtually disappeared into the depths of to the untrained eye. They have to be translated
his fleshy sole. for us. In the same way the body is turned into
While it may be starting to look like medi- something accessible and enlightening by the
cal imaging technology has been developed illustrator, so must the messages hidden in the
exclusively for one boy, I offer these examples as a grays and grains of these remarkable images be
reminder of just how pervasive this technology has made understandable if they are to meet their
become. The fantastic leaps, excluding my son’s, great potential. Whether it is the surgeon who will
that have been made over the past few years have be guided by this information or the radiologist
added several powerful weapons to the diagnos- who provides it, both must be able to reconstruct
tic arsenal by giving those responsible for our care from two d imensions the three-dimensional pul-
unprecedented and generally painless access to sating r eality waiting nervously in the office or on
our bodies. the table, and they must be able to do this while
While the term “medical imaging” may be new, constantly facing that other dimension–time. And
the making of medical images certainly isn’t. The that’s where the building of “experience” needs
work of countless medical illustrators has long something of a jumpstart.
provided the foundation for our understand- When we look at anything for the first time, we
ing of human anatomy. Working from the real may not know what to make of it. But eventually,
thing, whether in the morgue or the operating with repeated viewings, over time we gradually
room, medical illustrators have been our guides learn to see differences, to identify growth, transfor-
to the complexity of the human body. In their mation, disappearance and even danger. Learning
roles as visual communicators, they understand to recognize change is both a source of endless
that simply recording everything in front of them curiosity and an essential tool for the survival of all
doesn’t necessarily translate into useful information. species. But we aren’t talking about all species here.
Never losing sight of the purpose of each image We’re concerned with just one patient at a time.
they make, they edit as they go, focusing on the Being able to scan any area of a patient’s body is
essentials while minimizing or eliminating that remarkable, but if we don’t know what that area is
which is unnecessary. supposed to look like in the first place, how would
The best medical illustrations are often we know if it’s changed?
stunning works of art as well as utilitarian Here’s a simple idea. Why not gather together
documents. But they all, whether spectacular or pairs of actual images of the same area of the
not, are the result of careful observation based body and put them side by side? One to show the
on years of experience, well-honed technical skill, anatomy in its normal state, the other to present
FOREWORD vii
that same anatomy in its changed or abnormal while moving all around the body, and you just
state. Then, without obliterating the images, provide might find yourself not only seeing the d
ifferences
just enough labels and leader lines to know exactly more quickly, but also recognizing their significance.
what you’re looking at. And finally offer a brief and No need to take my word for it, however. Just
yet completely adequate description of the particu- turn the page.
lar pathology. Repeat this idea over and over again, David Macaulay
viii FOREWORD
Acknowledgments
We want to begin by expressing our gratitude to us to use these facilities, and especially to
Elsevier for accepting our book proposal for this Mr. Chaz Eartly for his technical expertise and
atlas. We especially want to thank Ms. Anne Lenehan to Mr. Gary Stuby, department administrator of
and Ms. Madelene Hyde for s hepherding the pro- diagnostic imaging at the hospital, for his support.
posal through the Elsevier book approval process We thank all the technologists in both facilities
and for encouragement during its development. for their work in producing the especially distinct
Ms. Christine Abshire was our developmental editor images we needed for this book.
at Elsevier and is thanked for her skill and assistance Dr. Scott Mattson, Medical Director,
on this project. Echocardiology Laboratory, Cardiovascular MRI
The actual process of converting our initial Laboratory, Lutheran Hospital of Indiana, graciously
PowerPoint images to the professional quality plates provided us with some of the cardiac images, and
that appear here was done by Mr. Chris Oakes of we very much appreciate his efforts on our behalf.
Graphic World Inc. in St. Louis, who tolerated us for We are grateful to Dr. Chandana Lall,
two days as we asked him to move numerous leaders Department of Radiology, Indiana University
and labels microns so that the plates were printed Medical Center, for the CT image of pancreatic
exactly the way we wanted them to be seen. We also cancer.
want to thank Ms. Cindy Geiss, Ms. Kate Challans and Ms. Lowene Stipp, administrative assistant at the
Mr. Mark Lane of Graphic World for helping to make Indiana University School of Medicine-Fort Wayne,
our visit there fun and very productive. assisted us with many of the administrative tasks
We are very grateful for the dedicated efforts of associated with assembling this book, and we thank
Ms. Beula Christopher, who did the final conversion her for this work.
of our electronic files to the printed page. And we We are honored that Mr. David Macaulay agreed
thank Dr. Diana Patterson for helping us check the to write the Foreword and want to thank him for
proofs of this book. doing so.
Approximately half of the images in this atlas We are grateful to our wives,
were produced using the facilities at The Imaging Deborah Meyer-Vilensky, Ellen Weber, Nancy Sarosi and
Center in Fort Wayne, and we are very grateful to Susan Stoddard, for their love and patience during
its founder, Dr. Robert Connor, for his support and the development and implementation of this project.
encouragement. A similar number of images for Finally, we thank the medical students who
this atlas were obtained using the facilities of Fort taught us how to teach and how to create
Wayne Radiology and Parkview Memorial Hospital anatomy/radiology books that both interest and
in Fort Wayne. We are grateful to the hospital and instruct them in the beauty and complexity of
the physicians of Fort Wayne Radiology for allowing human anatomy.
Acknowledgments ix
This page intentionally left blank
Introduction
such as a lung mass, as well as review available
c linical information that might explain the enlarged
lymph nodes. Further studies or procedures, such
as a biopsy, might be indicated to discern a specific
diagnosis. An elaborate diagnostic process is thus
initiated by the almost instant pattern recognition of
an abnormal appearing axilla.
Medical students are at the beginning of the
long process of developing the ability to quickly
recognize the anatomic differences between health
and when disease or trauma results in morphologic
derangement. Existing anatomy illustrations do not
typically aid the student’s ability to rapidly perceive
these morphologic changes. In this atlas we provide
visual clarity of these differences by providing
side-by-side images of the normal and pathologic
condition in patients of similar body habitus, or
highlight differences in the ipsilateral and contralat-
eral sides. In this way we facilitate the acquisition of
pattern recognition skills in students.
We include here images of p athologic condi-
tions that have direct gross anatomic c orrelations
and that can be visualized using routine procedures
The axial CT image of the axilla (above) is from including radiographs, CT, MR, and u ltrasound.
a patient with suspicious findings. A radiologist, These conditions typically are also discussed in two
upon viewing this image on the screen, would widely utilized texts in medical gross anatomy, Gray’s
instantly recognize those findings and search for Anatomy for Students, 2nd edition, and Clinically
corroborating abnormalities on other images. The Oriented Anatomy, 6th edition, and we therefore
radiologist is alerted because he/she compares provide specific page r eferences to these texts.
the above image with a stored mental image of a Our labeling of structures in the images
normal axilla. This knowledge of normal radiologic (most important structures are in bold) will
anatomy was acquired by the radiologist during enable the beginning student to comprehend
residency and subsequent years of practice. the region. We do not present an explanation of
Training and practice resulted in the skill of pattern imaging techniques (e.g., CT, MR) because such
recognition needed for that image to be meaningful. explanations are available in numerous texts
With the advent of modern diagnostic imaging and atlases, as is information on the standard
technologies (e.g., CT, MR, ultrasound), the role of orientations for radiographic images. However,
radiologic imaging has increased tremendously for the images displayed we do indicate the
in medical education so that now even first-year
medical students in gross anatomy are expected to
identify normal and pathologic anatomic structures
on plain, MR and CT images. But these students
don’t have the benefit of years of examining
patients with normal anatomy. This is the reason we
created this book.
This second image to the right is a matched
“normal” for the abnormal CT that is shown above.
By “matched” we mean that the axial sections are
at the same level in two patients with similar body
habitus. Note that the second image does not show
the four globular structures in the axilla that are dis-
tinctive in the first image. Those are abnormal axil-
lary lymph nodes. Normal axillary nodes are typically
much smaller and/or not as homogenous because
they consist of tissues with different CT densities.
The prominence and appearance of the abnormal
nodes on the first image prompt the radiologist
to look more carefully at the contralateral axilla,
the mediastinum, the pulmonary hila, and in the
lower neck for additional suspicious lymph nodes.
The radiologist will look for other imaging findings
INTRODUCTION xi
imaging modality (e.g., MR vs. CT) and where The vast majority of the images in this atlas
appropriate provide a brief explanation as to why are from routine imaging procedures done at the
this technique is typically the one used to evaluate Imaging Center (Fort Wayne, IN) and the r adiologic
the specific clinical condition. And we also often facilities within the practice of Fort Wayne Radiology,
provide limited clinical information, although we at which two of us (ECW and TES) are practicing
recommend that the student refer to the pages radiologists. A few images were obtained from other
listed for the anatomy texts or our previous book, sources and the pertinent attributions are noted on
Netter’s Concise Radiologic Anatomy, for more the associated plates. We wish to emphasize that no
comprehensive clinical information. patient underwent any additional (i.e., not clinically
The student should be aware that images from necessary) radiologic procedure in order to obtain
ultrasound procedures are not as intuitive as are the images used in this atlas.
plain films and CT and MR images. Unlike these During the preparation of this book, the
modalities, ultrasound images often show only limited authors had the opportunity to meet
non-orthogonal sections of anatomy. As illustrated Mr. David Macaulay at the 2008 meeting of the
in some of our ultrasound images, intensity of blood American Association of Clinical Anatomists. He
flow may also be represented on ultrasound images had just completed, The Way We Work: Getting to
by arbitrary colors using the Doppler principle (for Know the Amazing Human Body. Similar to his previ-
example, see page 144). ous books illustrating the building and operational
In some cases images for this atlas were obtained principles of mechanical machines, common and
from an imaging modality that may not be the one uncommon, this work provides an outstanding
most commonly used for that clinical condition introduction to human form and function.
because it displays the anatomy of a specific Mr. Macaulay’s skills as an author and illustrator
abnormality very well (see page 33). In addition, the make the complicated seem (relatively) simple and
images in this atlas were selected partly because only we are honored that he agreed to write a Foreword
one anatomic derangement is apparent; in clinical for this book, which visually reveals how disease
situations patients often have multiple abnormalities. alters normal human anatomy.
xii INTRODUCTION
Hydrocephalus 1-1
Lateral ventricles Dilated lateral ventricles
Axial MR images of the normal brain (left) and one with hydrocephalus (right)
at the level of the lateral ventricles. Hydrocephalus can result from excess
cerebrospinal fluid (CSF) production, interference with the absorption of CSF
(communicating hydrocephalus), or obstruction of CSF flow (obstructive or
noncommunicating hydrocephalus) from the ventricles.
Gray’s Anatomy for Students, 2e: Hydrocephalus (p. 834)
Clinically Oriented Anatomy, 6e: Hydrocephalus (p. 885)
Head and Neck 1
1-2 Cephalhematoma
Lateral ventricles Cephalhematoma
Axial CT image of the cranium of an infant. A cephalhematoma is an
accumulation of blood between the skull and the periosteum of a newborn
and often is a consequence of a forceps-assisted delivery. The hematoma
usually calcifies, and then progresses to more mature ossification, as shown
here. Parents are often quite concerned with the easily palpable “bump” on
the skull, but can be reassured that this condition always resolves; the lesion is
resorbed and disappears.
COA: Cephalhematoma (p. 861)
2 Head and Neck
Metastatic Brain Tumors 1-3
Metastatic tumors
Metastatic tumors Lateral ventricles
Contrast-enhanced axial (left) and coronal (right) MR images of the same
patient. The bright round lesions within the brain parenchyma are metastases
(five are labeled). These tumors are visible because of the leakage of contrast
material from the blood into the interstitial spaces of the tumors. This is unlike
normal brain parenchyma in which the blood-brain barrier limits the size and
types of molecules that can leave the intravascular space.
GAS: Brain tumors (p. 835)
COA: Metastasis of tumor cells to dural venous sinuses (p. 876)
Head and Neck 3
1-4 Primary Brain Tumor
Choroid plexus Lateral ventricles
Sigmoid sinus Neuroectodermal neoplasm
Cerebellum
Contrast-enhanced coronal (left) and axial (right) MR images demonstrate a
neuroectodermal (primary brain) tumor in the left parietal lobe. The patient
presented with confusion and slurred speech.
GAS: Brain tumors (p. 835)
4 HEAD AND NECK
Pituitary Tumor 1-5
Optic chiasm Lateral ventricles Optic chiasm
Pituitary gland Sphenoid sinus Tumor Pituitary
gland
Tumor
Coronal contrast-enhanced MR image of a patient with a pituitary microad-
enoma (upper right) compared to a patient with normal anatomy (upper left).
Lacking the blood-brain barrier, the normal pituitary enhances intensely
(bright area), outlining pituitary microadenomas that are often relatively
hypovascular (dark lesion within the pituitary). The upper right MR image was
requested for a patient with hyperprolactinemia. The bottom MR image is
for a patient who has a pituitary macroadenoma in which the tumor is clearly
impinging on the optic chiasm, resulting in visual field deficits.
GAS: Cranial nerve lesions (p. 855)
COA: Visual field defects (p. 1080)
HEAD AND NECK 5
1-6 Pineal Gland Cyst
Corpus callosum
Pineal gland Sphenoid sinus
Sphenoid sinus Pineal gland cyst
Sagittal MR images, with the normal image on the left. The patient shown on the
right has a benign pineal gland cyst. Before the development of MRI, pineal
cysts were considered rare. Now, small (<5 mm) pineal cysts are considered to be
common incidental benign findings. Larger cysts may be symptomatic, often
associated with headaches in 40- to 49-year-old women.
6 HEAD AND NECK
Papilledema—Pseudotumor Cerebri 1-7
Cerebellum Cerebellum
Pituitary gland CSF filling the
pituitary (hypophyseal) fossa
Sagittal contrast-enhanced MR images. A brightly enhancing pituitary
gland (hypophysis) with a normal nearly spherical shape is shown on the left.
The patient on the right presented with headache and was found to have
papilledema (a sign of increased intracranial pressure), raising clinical con-
cern for brain tumor (see Primary Brain Tumor, page 4). The MR image showed
the appearance of an “empty sella” (anatomically, an empty hypophyseal
fossa) consistent with pseudotumor cerebri; the latter is related to a deficient
diaphragma sellae, a benign syndrome associated with papilledema.
COA: Papilledema (p. 911)
HEAD AND NECK 7
