What is Empty Sella?

The "sella turcica" is the bony pocket in the skull that holds the pituitary gland. In Empty Sella Syndrome, the sella is partially or completely filled with cerebrospinal fluid (CSF), and the pituitary is flattened or compressed against the floor of the sella. On an MRI, it looks like the sella is "empty."

Types:

• Primary Empty Sella: Usually a benign anatomical variant. The membrane covering the pituitary (diaphragma sellae) is weak or absent, allowing CSF to push down on the gland.
• Secondary Empty Sella: Caused by pituitary surgery, radiation, tumor shrinkage, or Sheehan's Syndrome.

Who is affected?

More common in women, especially those who are overweight and have multiple pregnancies.

Symptoms:

Most people have NO symptoms. It's usually an incidental finding on MRI. However, some may have:

• Headaches.
• Vision problems (rare).
• Hormone deficiencies (rare in primary; common in secondary).

Diagnosis:

• MRI: The key finding.
• Hormone Testing: To check for hypopituitarism.

Treatment:

• Primary Empty Sella: Usually none. Reassurance.
• Hormone Replacement: If deficiencies are found.