Overview Of Empty Sella Syndrome
Empty sella syndrome is a condition in which the pituitary gland shrinks or becomes flattened.
Commonly Associated With
Pituitary – empty sella; Partial empty sella
Causes Of Empty Sella Syndrome
The pituitary is a small gland located just underneath the brain. It is attached to the bottom of the brain by the pituitary stalk. The pituitary sits in a saddle-like compartment in the skull called the sella turcica. In Latin, it means Turkish seat.
When the pituitary gland shrinks or becomes flattened, it cannot be seen on an MRI scan. This makes the area of the pituitary gland look like an “empty sella.” But the sella is not actually empty. It is often filled with cerebrospinal fluid (CSF). CSF is fluid that surrounds the brain and spinal cord. With empty sella syndrome, CSF has leaked into the sella turcica, putting pressure on the pituitary. This causes the gland to shrink or flatten.
Primary forms of this syndrome occur when one of the layers (arachnoid) covering the outside of the brain bulges down into the sella and presses on the pituitary.
Secondary forms occur when the sella is empty because the pituitary gland has been damaged by:
- A tumor
- Radiation therapy
- Surgery
- Trauma
- Empty sella syndrome may be seen in a condition called pseudotumor cerebri, which mainly affects young, obese women and causes the CSF to be under higher pressure.
The pituitary gland makes several hormones that control other glands in the body, including the:
- Adrenal glands
- Ovaries
- Testicles
- Thyroid
- A problem with the pituitary gland can lead to problems with any of the above glands and abnormal hormone levels of these glands.
Symptoms Of Empty Sella Syndrome
Often, there are no symptoms or loss of pituitary function.
If there are symptoms, they may include any of the following:
- Erection problems
- Headaches
- Irregular or absent menstruation
- Decreased or no desire for sex (low libido)
- Fatigue, low energy
- Nipple discharge
Exams & Tests
Primary empty sella syndrome is most often discovered during an MRI or CT scan of the head and brain. Pituitary function is usually normal.
The health care provider may order tests to make sure the pituitary gland is working normally.
Sometimes, tests for high pressure in the brain will be done, such as:
- Examination of the retina by an ophthalmologist
- Lumbar puncture (spinal tap)
Treatment Of Empty Sella Syndrome
For the primary form:
- There is no treatment if pituitary function is normal.
- Medicines may be prescribed to treat any abnormal hormone levels.
- For secondary empty sella syndrome, treatment involves replacing the hormones that are missing.
In some cases, surgery is needed to repair the sella turcica.
