The subdiaphragmatic cistern: historic and radioanatomic findings

Antonio Di Ieva*, Manfred Tschabitscher, Christian Matula, Fuminari Komatsu, Mika Komatsu, Giovanni Colombo, Camillo Sherif, Renato J. Galzio

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)

Abstract

Background: In the past, sporadic demonstrations of the existence of a subarachnoid subdiaphragmatic cistern have been published. The aim of this study was to evaluate the anatomical characteristics of the subdiaphragmatic cistern of the pituitary gland. Methods: After a complete review of the literature published on the topic, we report anatomical observations of the subdiaphragmatic cistern and its relationship to the pituitary gland and to the chiasmatic cistern. Ten cadaveric heads were studied using different techniques and surgical methods (plastination, plastic casts of the subarachnoid spaces, microscopic and transsphenoidal endoscopic approaches). Moreover, 3-T magnetic resonance images of ten healthy volunteers were analyzed to investigate the presence and anatomical variability of the subdiaphragmatic cistern. Results: By means of our qualitative radioanatomic study, we found that the roof of the subdiaphragmatic cistern is formed by the diaphragma sellae, the floor by the superior face of the pituitary gland, the lateral walls by the arachnoidea extending laterally through the medial walls of the cavernous sinus, and the medial walls by the infundibular stem. The subdiaphragmatic cistern communicates by means of the ostium of the diaphragm with the chiasmatic cistern. Conclusion: We confirmed the existence of the subdiaphragmatic cistern. The overused term "suprasellar cistern" refers more to a complex of cisterns, formed by the subdiaphragmatic cistern, below the diaphragma sella, and by the chiasmatic cistern, above it, in direct communication with the lamina terminalis and carotid cisterns.

Original languageEnglish
Pages (from-to)667-674
Number of pages8
JournalActa Neurochirurgica
Volume154
Issue number4
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

Bibliographical note

Erratum can be found in Acta Neurochirurgica, Volume 154(2), 381, http://dx.doi.org/10.1016/10.1007/s00701-011-1248-2

Keywords

  • arachnoid
  • cerebrospinal fluid
  • cistern
  • pituitary gland
  • pituitary stalk
  • sellar region
  • subarachnoid space
  • subdiaphragmatic cistern

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