Empty sella syndrome

Empty sella syndrome is a condition characterized by an anatomical abnormality in the sella turcica, a cavity in the skull that houses the pituitary gland.

When the sella turcica becomes filled with cerebrospinal fluid instead of the pituitary gland, it leads to what is termed 'empty sella.

' Despite the name, the pituitary gland is often still present, but it is compressed and flattened along the walls of the sella turcica.

This condition can be classified into primary and secondary forms.

Primary empty sella syndrome occurs when an opening in the diaphragma sellae, a small membrane covering the sella turcica, allows cerebrospinal fluid to enter and put pressure on the pituitary gland.

Secondary empty sella syndrome may arise following surgery, radiation therapy, or pituitary gland disorders that lead to shrinkage or removal of the pituitary tissue.

Symptoms of empty sella syndrome vary widely, ranging from none at all to symptoms of pituitary hormone deficiencies, such as fatigue, headaches, or vision problems.

In some cases, it can be associated with conditions like high blood pressure or obesity.

Diagnosis is typically achieved through imaging studies, where MRI or CT scans of the brain can reveal the characteristic appearance of an empty sella.

Treatment depends on the presence and severity of symptoms, where hormone replacement therapy might be necessary if there is a significant hormone deficiency.

In many cases, however, empty sella syndrome does not require treatment and is discovered incidentally during imaging for other conditions.