(See also Overview of the Pituitary Gland Overview of the Pituitary Gland The pituitary is a pea-sized gland that is housed within a bony structure (sella turcica) at the base of the brain. The sella turcica protects the pituitary but allows very little room for expansion... read more .)
People with empty sella syndrome have a defect in the tissue barrier that normally keeps the cerebrospinal fluid around the brain separate from the sella turcica. As a result, cerebrospinal fluid puts increased pressure on the pituitary gland Overview of the Pituitary Gland The pituitary is a pea-sized gland that is housed within a bony structure (sella turcica) at the base of the brain. The sella turcica protects the pituitary but allows very little room for expansion... read more and the walls of the sella turcica. The sella turcica may enlarge, and the pituitary gland may shrink, causing the sella to appear empty on imaging studies.
Empty sella syndrome occurs most often in middle-aged women who are overweight and who have high blood pressure. Less commonly, the condition occurs after pituitary surgery, radiation therapy, or infarction (death) of a pituitary tumor.
The empty sella syndrome may cause no symptoms at all and seldom causes serious symptoms. About half of those affected have headaches, and some people have high blood pressure as well. In rare cases, there is leaking of the cerebrospinal fluid from the nose or problems with vision.
Empty sella syndrome can be diagnosed by computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more (CT) or magnetic resonance imaging Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more (MRI). Pituitary function is checked by measuring hormone levels in the blood to rule out hormone excess or deficiency. But pituitary function is usually normal.
Treatment is rarely needed. It is given only if the pituitary produces too much or too little hormones, depending on which hormones are affected. Treatment may be replacing the deficient hormone or giving drugs to decrease excess hormone production.