Fact-sheet: Empty sella syndrome


Updated on 09/03/2020 at 12:13 PM

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Definition

Intrasellar arachnoidocele.
Condition consisting of herniation of arachnoid tissue and CSF into the sella turcica.

Etiologies include:

  • Primary: mainly in postmenopausal women, thought to be due to CSF pulsation and pituitary involution
  • Secondary: after treatment of a pituitary adenoma, intracranial hypertension, or pituitary apoplexy

Clinical features

  • Asymptomatic
  • Intracranial hypertension with retro-orbital headaches
  • Visual field disturbance due to chiasmal prolapse
  • Rhinorrhea

Laboratory findings

Endocrinopathies

MRI

  • Harmonious enlargement of the sella turcica dimensions
  • Displacement of the pituitary gland against the dorsum or floor of the sella turcica, which is concave and symmetric
  • Pituitary stalk with a bell-clapper shape in a midline position
  • Sellar content isointense to CSF

Protocol: rapid sequences after gadolinium injection

Management

Surgical treatment if ocular complications or disabling rhinorrhea