Empty sella syndrome

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

The pituitary gland

Empty sella syndrome

Definition:

The pituitary gland is partially surrounded by a bony structure called the sella turcica. Normally, it is visible during a CT scan or MRI. In empty sella syndrome, the pituitary gland is not visible -- either because it has become flattened or has shrunk.

Causes, incidence, and risk factors:

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The pituitary gland is a small gland located at the base of the brain. It makes several hormones that control the function of other glands in the body, including the thyroid, the adrenal glands, and the ovaries or testes.

The pituitary gland is partly surrounded by a bony structure called the sella turcica ("Turkish saddle"). When the pituitary gland is not visible on CT or MRI scans of the sella turcica, the condition is referred to as empty sella syndrome.

Primary empty sella syndrome occurs when a small defect above the pituitary gland increases pressure in the sella turcica and causes the gland to flatten out along the walls of the sella. Secondary empty sella syndrome occurs when the sella is empty because the pituitary gland has shrunk following an injury, surgery, or radiation therapy.

Primary empty sella syndrome is most often found during radiological imaging of the brain. Pituitary function is usually normal, and patients do not have any symptoms. The hormone prolactin is mildly elevated in 10-15% of patients, and the elevated prolactin may interfere with normal function of the testes or ovaries.

Medications such as bromocriptine that suppress prolactin production are effective in correcting the problem.

Patients with an empty sella due syndrome to destruction of the pituitary gland have signs and symptoms caused by partial or complete loss of pituitary gland functions. The causes and symptoms of pituitary insufficiency are reviewed in the article on hypopituitarism.

Empty sella syndrome may be associated with abnormal pituitary function in children. Low levels of growth hormone (GH) is most common, but other pituitary hormones may also be deficient.