Causes of vacuolar pteronyssinus include obesity, multiple pregnancies, congenital developmental defects, hydrocephalus, benign intracranial pressure elevation, etc. Some do not require special treatment, and medication is basically ineffective, while serious cases require surgery. Vacuolar pterygoid refers to the presence of abnormal arachnoid structure in the pterygoid area and the base of the skull, generally due to the presence of structural or functional defects in the arachnoid membrane, which leads to the cerebrospinal fluid continuously entering into the interior of the pterygoid along with the brain pulsation, forming arachnoid cysts, and pressing the pituitary gland, resulting in the alteration of the pituitary gland’s function. Causes of vacuolar pterygoid are obesity, multiple pregnancies, if there are no obvious symptoms do not need special treatment. If there is hydrocephalus, benign intracranial pressure increase, congenital developmental abnormalities, headache, dizziness, nausea, vomiting, visual field defects, vision loss need to take surgical treatment, adhesion release or cerebrospinal fluid drainage surgery. Therefore, vacuolar pterygoid saddle needs to go to the hospital for examination to clarify the specific cause of the disease, taking medication does not help, for the cause of the disease to be dealt with.