Empty sella syndrome

Empty sella MRI

Empty sella syndrome (ESS) is a medical condition characterized by the presence of a sella turcica that appears to be empty. The sella turcica is a saddle-shaped depression in the sphenoid bone at the base of the skull, which houses the pituitary gland. In ESS, the pituitary gland is either shrunken or flattened, making the sella turcica appear empty on imaging studies.

Classification[edit | edit source]

Empty sella syndrome is classified into two types:

Primary empty sella syndrome: This occurs when a defect in the diaphragma sellae, a small membrane that covers the sella turcica, allows cerebrospinal fluid (CSF) to enter the sella and compress the pituitary gland.
Secondary empty sella syndrome: This form occurs when the pituitary gland is damaged due to surgery, radiation therapy, pituitary apoplexy, or other conditions that affect the gland.

Symptoms[edit | edit source]

Many individuals with empty sella syndrome are asymptomatic and the condition is often discovered incidentally during imaging studies for other reasons. When symptoms do occur, they may include:

Headache
Visual disturbances
Hypopituitarism (deficiency of one or more pituitary hormones)
Hyperprolactinemia (elevated levels of prolactin)

Diagnosis[edit | edit source]

The diagnosis of empty sella syndrome is typically made through imaging studies such as:

Magnetic resonance imaging (MRI)
Computed tomography (CT) scan

Treatment[edit | edit source]

Treatment for empty sella syndrome depends on the presence and severity of symptoms. Asymptomatic individuals usually do not require treatment. Symptomatic treatment may include:

Hormone replacement therapy for hypopituitarism
Management of headaches and visual disturbances

Prognosis[edit | edit source]

The prognosis for individuals with empty sella syndrome is generally good, especially for those who are asymptomatic. Regular monitoring and follow-up are recommended for those with hormone deficiencies or other complications.