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Empty Sella Syndrome

An anatomical condition in which the pituitary gland is flattened within the sella turcica, leaving a CSF-filled space.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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 Syndrome?

Empty sella syndrome is an anatomical condition in which the pituitary gland is flattened due to herniation of the arachnoid membrane into the sella turcica, with a CSF-filled space forming above it. The pituitary gland does not disappear; however, on MR imaging, the sella turcica appears 'empty'.

Primary form: due to inadequate development of the sellar diaphragm or increased intracranial pressure; common in idiopathic intracranial hypertension, obesity and multiparous women. Secondary form: develops after radiotherapy or surgery for a pituitary adenoma or after apoplexy.

The vast majority is asymptomatic. In a small number of cases, hypopituitarism, headache, visual disturbance or CSF rhinorrhea may develop. Diagnosis is made by MRI; pituitary hormone profile is measured for functional evaluation.

Symptoms

Mostly asymptomatic (incidentally detected)
Headache (most common symptom)
Visual disturbance (optic chiasm traction — rare)
Fatigue and weakness (if hypopituitarism is present)
Irregular menses and decreased libido
CSF nasal discharge (CSF rhinorrhea — rare, serious complication)

Risk Factors

Obesity
Multiparous women
Idiopathic intracranial hypertension
History of pituitary surgery or radiotherapy
Previous pituitary apoplexy

When to See a Doctor?

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

  • For endocrinology evaluation when an empty sella finding is reported on pituitary MRI
  • When chronic headache and visual disturbance are present together
  • When fatigue and hormonal disorder symptoms accompany
  • When clear fluid drains from the nose (CSF rhinorrhea — urgent ENT evaluation)

Treatment Methods

01
Asymptomatic primary empty sella: no treatment needed, periodic monitoring is sufficient
02
When hypopituitarism is detected: replacement of missing hormones (cortisol, thyroid, gonadal, GH)
03
For headache: treatment for idiopathic intracranial hypertension (weight loss, acetazolamide)
04
For visual disturbance: neuro-ophthalmology + neurosurgery evaluation
05
For CSF rhinorrhea: surgical repair

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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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.