INFORMATION ON EMPTY SELLA SYNDROME

Empty sella syndrome is lack of the pituitary gland on radiological imaging of the sella turcica, a bony structure that partially surrounds the gland.

CAUSES OF EMPTY SELLA SYNDROME

The pituitary gland is a small gland located at the foot of the brain. It makes a number of 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 somewhat surrounded by a bony structure called the sella turcica ("Turkish saddle"). When the pituitary gland is not noticeable 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 anatomical defect above the pituitary gland increases pressure in the sella turcica and causes the gland to flatten out along the walls of the sella. When the sella is vacant because the pituitary gland has regressed following an injury such as head trauma or an event such as surgery or radiation therapy, the condition is called secondary empty sella syndrome.

Primary empty sella syndrome is most often an minor finding during radiological imaging of the brain. Pituitary function is generally normal, and patients do not have any signs. The hormone prolactin is mildly go high in 10% to 15 % of patients, and the elevated prolactin may get in the way with normal function of the testes or ovaries.
Medications such as bromocriptine that hold back prolactin production are effective in correcting the problem

SYMPTOMS OF EMPTY SELLA SYNDROME

Primary empty sella syndrome:
• Infrequent symptoms due to elevated prolactin levels
• Irregular or missing menstruation
• Decreased libido
• Impotence (erectile dysfunction)
Generally there are no symptoms of loss of pituitary function.
Secondary empty sella syndrome: symptoms are observed due to loss of pituitary gland function.

TREATMENT OF EMPTY SELLA SYNDROME

Primary empty sella syndrome:
• No specific treatment if pituitary function is normal
• Medication to lower down the prolactin levels if the prolactin level is high and interfering with function of the gonads.
Secondary empty sella syndrome:
Therapy is directed at replacing hormones that are deficient as a result of abnormal pituitary gland function.