Empty sella syndrome is a condition in which the pituitary gland shrinks or becomes flattened.
The pituitary gland is a small gland located at the base of the brain. It sits in a saddle-like compartment in the skull called the "sella turcica," which in Latin means "Turkish saddle."
When the pituitary gland shrinks or becomes flattened, it cannot be seen on MRI scans, giving the appearance of an "empty sella." This is referred to as empty sella syndrome.
The pituitary makes several hormones that control the other glands in the body, including the:
Primary empty sella syndrome occurs when a hole in the membrane covering the pituitary gland allows fluid in, which presses on the pituitary.
Secondary empty sella syndrome occurs when the sella is empty because the pituitary gland has been damaged by:
Empty sella syndrome may be seen in a condition called pseudotumor cerebri. This is a condition seen most commonly in obese women.
Often, there are no symptoms or loss of pituitary function.
Patients with empty sella syndrome may have symptoms caused by a partial or complete loss of pituitary gland function. For more information, see hypopituitarism.
Primary empty sella syndrome is most often discovered during radiological imaging of the brain. Pituitary function is usually normal.
The health care provider may test pituitary gland function to make sure that the gland is working normally.
Sometimes tests for high pressure in the brain will be done, such as:
The hormone prolactin is a little high in a small percentage of patients, which may interfere with the normal function of the testicles or ovaries.
For primary empty sella syndrome:
For secondary empty sella syndrome:
Primary empty sella syndrome does not cause health problems, and it does not affect life expectancy.
Complications of primary empty sella syndrome include mild hyperprolactinemia.
Complications of secondary empty sella syndrome are related to the cause of pituitary gland disease or to the effects of too little pituitary hormone.
Contact your health care provider if you develop symptoms of abnormal pituitary function, such as a disrupted menstrual cycle or impotence.
Melmed S, Kleinberg D. Anterior pituitary. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. Philadelphia, PA: Saunders Elsevier; 2008:chap 8.