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Empty Sella: Clinical Approach

Radiologic finding of an enlarged sella turcica filled with cerebrospinal fluid and a flattened pituitary gland.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Empty Sella: Clinical Approach?

Empty sella is a radiologic appearance in which the sella turcica is partially or completely filled with cerebrospinal fluid while the pituitary gland is flattened against the floor of the sella. It can be primary, due to a deficient diaphragma sellae, or secondary to surgery, radiotherapy, infarction or apoplexy.

Most patients are asymptomatic incidentally diagnosed during cranial imaging. A subset develops chronic headache, visual disturbance, partial or panhypopituitarism, hyperprolactinemia or features of idiopathic intracranial hypertension. Pediatric cases may present with growth retardation.

Evaluation includes a complete pituitary hormone panel, dynamic stimulation tests when indicated, ophthalmologic examination with visual fields, and dedicated pituitary MRI. Management ranges from observation in asymptomatic patients to hormone replacement, treatment of intracranial hypertension and rarely surgical repair for cerebrospinal fluid leak.

Symptoms

Chronic headache
Visual disturbances
Symptoms of hypopituitarism
Galactorrhea and amenorrhea
Decreased libido
Growth retardation in children
Cerebrospinal fluid rhinorrhea (rare)

Risk Factors

Multiparity in women
Obesity and intracranial hypertension
Previous pituitary surgery
Cranial radiotherapy
Sheehan syndrome
Pituitary apoplexy
Congenitally deficient diaphragma sellae

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent headaches without explanation
  • Visual field defects
  • Symptoms of adrenal or thyroid failure
  • Menstrual irregularity and infertility
  • Growth failure in children
  • Suspicious incidental finding on cranial imaging

Treatment Methods

01
Periodic clinical and hormonal follow-up
02
Hormone replacement when deficiency is documented
03
Dopamine agonists for hyperprolactinemia
04
Treatment of intracranial hypertension
05
Ophthalmologic and neurosurgical evaluation
06
Cerebrospinal fluid leak repair when needed
07
Lifestyle and weight management

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.