A Simple Guide to Empty Sella Syndrome, Diagnosis, Treatment and Related Conditions

This book describes Empty Sella Syndrome, Diagnosis and Treatment and Related Diseases

Empty sella syndrome is a rare disorder linked to a part of the skull called the sella turcica.

The sella turcica is a saddle-shaped depression in the sphenoid bone at the base of the skull that holds the pituitary gland.

Even if the patient has empty sella syndrome, the sella turcica is not really empty.

In fact, it indicates the sella turcica is either partially or totally filled with cerebrospinal fluid (CSF).

People with empty sella syndrome also have smaller pituitary glands.

In some cases, the pituitary glands do not even appear on imaging tests.

When empty sella syndrome is produced by an underlying disorder, it is termed secondary empty sella syndrome.

When there is no known cause, it is termed primary empty sella syndrome.

Primary empty sella syndrome

The precise cause of primary empty sella syndrome is not clear.

It may be linked to a birth defect in the diaphragma sellae, a membrane that covers the sella turcica.

Some people are born with a small rupture in the diaphragma sellae, which can induce CSF to leak into the sella turcica.

Doctors are not sure whether this is a direct cause of empty sella syndrome or just a risk factor.

Empty sella syndrome involves about 4 times as many women as it does men.

Most women with empty sella syndrome are likely to be middle-aged, obese, and have high blood pressure.

Most cases of empty sella syndrome are undiagnosed due to their shortage of symptoms, so it is difficult to say whether gender, obesity, age, or blood pressure are factual risk factors.

Secondary empty sella syndrome

A number of things can produce secondary empty sella syndrome such as:
1. Head trauma
2. Infection
3. Pituitary tumors
4. Radiation therapy or surgery in the area of the pituitary gland
5. Disorders related to the brain or pituitary gland such as:
a. Sheehan syndrome,
b. Intracranial hypertension,
c. Neurosarcoidosis, or
d. Hypophysitis

When the pituitary gland becomes smaller or flattened, it cannot be visualized on an MRI scan.

This makes the pituitary gland appear like an "empty sella."

But the sella is not really empty.

It contains a full volume of cerebrospinal fluid (CSF).

CSF is the tissue fluid that encloses the brain and spinal cord.

With empty sella syndrome, CSF has seeped out into the sella turcica, adding pressure on the pituitary.

This induces the gland to reduce in size or flatten.

Frequently, there are no symptoms or even failure of pituitary function.

Many people with empty sella syndrome also develop chronic headaches.

Infrequently, empty sella syndrome is linked with pressure increasing in the skull which causes:
1. Spinal fluid leaking from the nose
2. Swelling of the optic nerve inside the eye
3. Vision disorders

CT scans or MRI scans of the brain can determine whether the patient has partial or total empty sella syndrome.

Empty sella syndrome normally does not need treatment unless it is causing symptoms.
1. There is no treatment if pituitary function is normal.
2. Medicines may be given to treat any abnormal hormone levels.
3. Surgery to prevent CSF from leaking out of the nose

TABLE OF CONTENT
Introduction
Chapter 1 Empty Sella Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Hypopituitarism
Chapter 8 Life and Death of Pituitary Gland Cell
Epilogue

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