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The Empty Sella Syndrome

Description

The empty sella syndrome refers to the gross or radiographic appearance, with no apparent pituitary tissue seen in the sella turcica (it looks empty). There may be a real loss of pituitary tissue or the pituitary may have been compressed against the sides of the sella.


 

Mechanisms of the empty sella:

(1) compression of the pituitary gland by an arachnoid diverticulum (an intrasellar arachnoidocele)

(2) atrophy/destruction of the pituitary gland

 

Causes of an arachnoid diverticulum:

(1) congenital (primary) defect in the sellar diaphragm

(2) acquired defect in the sellar diaphragm (associated with benign intracranial hypertension, radiation, surgery)

 

Causes of pituitary gland atrophy/destruction:

(1) infarction

(2) radiation

(3) pituitary surgery

 

Clinical findings:

(1) normal pituitary function or hypopituitarism

(2) visual field defects (if the optic chiasm prolapses downwards)

(3) hyperprolactinemia due to traction on the pituitary stalk

 


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Specialty

ICD-10