Sellar arachnoid cysts are benign fluid-filled masses that can cause loss of pituitary gland function, visual loss and headache. The arachnoid is a thin delicate membrane that surrounds the brain and spinal cord.
Arachnoid cysts occurring in the sella and suprasellar region are relatively uncommon. Like arachnoid cysts in other parts of the intracranial space, sellar arachnoid cysts are thought to develop from an arachnoid pocket or diverticulum that progressively fills with cerebrospinal fluid (CSF). As these benign cysts enlarge, they can put pressure on the adjacent pituitary gland, optic chiasm and nerves and surrounding skull base membranes, leading to loss of pituitary gland function, visual loll and/or headaches.
Who is Affected?
Sellar arachnoid cysts can occur in people of any age but are most often identified in adults during evaluations for headaches, visual changes, or hormonal imbalances. They are relatively rare and are often discovered incidentally on brain imaging performed for other reasons.
Symptoms + Causes
Sellar Arachnoid Cyst Symptoms & Causes
Symptoms
Symptoms depend on the size and location of the cyst and its effect on nearby structures. They may include:
Headaches (often persistent or worsening)
Vision problems, including blurred or double vision
Loss of peripheral vision due to optic chiasm compression
Hormonal changes, such as fatigue, menstrual irregularities, or decreased libido
Rarely, balance issues or other neurological symptoms
Causes
The exact cause of sellar arachnoid cysts is not fully understood. They are believed to arise from congenital developmental abnormalities of the arachnoid membrane, which allows cerebrospinal fluid to collect and form a cyst. Most are not associated with trauma, infection, or tumors.
When to See a Doctor
Seek medical attention if you experience any of the following symptoms. Early diagnosis and treatment can help prevent permanent vision loss or significant pituitary dysfunction.
Sudden or progressive vision changes.
Persistent or severe headaches.
Unexplained fatigue or hormonal symptoms.
Any new neurological changes.
Diagnosis
Sellar Arachnoid Cyst Diagnosis
Accurate diagnosis of sellar arachnoid cysts involves a comprehensive evaluation by a multidisciplinary team of neurosurgeons, neurologists, and neuroradiologists. The diagnostic process typically includes the following steps:
Your healthcare provider will begin by conducting a detailed medical history interview, gathering information about your symptoms, medical background, and any relevant family history. A comprehensive physical examination will also be performed to assess any neurological signs associated with the cyst.
To visualize and evaluate the sellar region, various neuroimaging techniques are employed. Magnetic Resonance Imaging (MRI) is the primary imaging modality used to identify and characterize sellar arachnoid cysts. It provides detailed cross-sectional images of the brain, allowing our experts to assess the location, size, and impact of the cyst on surrounding structures.
Since sellar arachnoid cysts can potentially affect pituitary gland function, hormone level testing may be conducted to assess any hormonal imbalances or deficiencies. Endocrine specialists collaborate closely with our team to analyze these results and provide valuable insights into the overall hormonal status.
We follow a collaborative approach to diagnosing sellar arachnoid cysts. Our team of experts, including neurosurgeons, neurologists, neuroradiologists, and endocrinologists, carefully review all clinical and diagnostic findings to arrive at an accurate diagnosis. This multidisciplinary evaluation ensures comprehensive assessment and optimal treatment planning tailored to your specific needs.
Treatment + Outcomes
Sellar Arachnoid Cyst Treatmentrn& Outcomes
Treatment Options
Not all sellar arachnoid cysts require surgery. Small, asymptomatic cysts can often be monitored with regular imaging and endocrine evaluations. For symptomatic cysts, treatment is typically surgical.
At Pacific Neuroscience Institute, we specialize in minimally invasive endoscopic endonasal surgery for sellar arachnoid cysts. This approach allows access to the cyst through the nasal passages, avoiding large incisions and minimizing recovery time. Our team pioneered a simplified cyst obliteration technique using an abdominal fat graft, described in the Journal of Neurosurgery (2012), which has shown excellent success rates and low complication rates.
Patient Outcomes
Most patients experience significant improvement in headaches and visual function following surgery. Hormonal function often stabilizes or improves, particularly with early intervention. Our approach prioritizes safety, minimally invasive techniques, and preserving normal pituitary and neurological function.
Managing Your Condition
Managing A Sellar Arachnoid Cyst
After treatment, ongoing monitoring may include periodic MRI scans and hormone evaluations. Our specialists provide long-term support to ensure stability of vision, hormone levels, and overall neurological health.
At the Pacific Pituitary Disorders Center, we have one of the world’s largest experiences in transsphenoidal endoscopic endonasal surgery. By incorporating leading-edge technology and instrumentation with proven surgical experience of over 2000 endonasal surgeries, we make arachnoid cyst surgery safer, less invasive and more effective.
FAQs + Resources
Learn More About a Sellar Arachnoid Cyst
Treatment for a sellar arachnoid cyst depends on its size, growth, and symptoms. Small, asymptomatic cysts may only require regular MRI scans and hormonal monitoring. If the cyst causes headaches, vision changes, or pituitary dysfunction, sellar arachnoid cyst surgery is often recommended. At Pacific Neuroscience Institute, our surgeons specialize in minimally invasive endoscopic endonasal surgery, using a cyst obliteration technique with an abdominal fat graft to safely drain and seal the cyst while minimizing the risk of recurrence.
Most people with a sellar arachnoid cyst have a very good prognosis, especially when the cyst is small and not causing symptoms. Many remain stable for years and require only periodic imaging. When symptoms such as headaches, hormonal imbalance, or vision changes do occur, surgery or targeted drainage can often relieve pressure on nearby structures like the pituitary gland and optic nerves. Long-term outcomes depend on the cyst’s size, location, and whether it affects hormone function, but with appropriate monitoring and treatment, most individuals recover well and maintain a high quality of life.
Our multidisciplinary team at Pacific Neuroscience Institute specializes in diagnosing and treating sellar arachnoid cysts. With expertise in minimally invasive and endoscopic techniques, our neurosurgeons tailor care to each patient’s needs, ensuring optimal outcomes and safety.
