Understanding Empty Sella Syndrome: Causes, Symptoms, and Treatment Options

Key Takeaways

  • Primary empty sella occurs in 80-90% of cases when a congenital defect allows cerebrospinal fluid to leak into the sella turcica, compressing the pituitary gland against the skull base.
  • Women aged 30-60 with obesity and hypertension face the highest risk, with the condition being 4-5 times more common in females than males.
  • Most patients (85%) remain completely asymptomatic and only discover the condition incidentally during brain MRI scans performed for other reasons.
  • Growth hormone deficiency affects up to 35% of patients with symptomatic cases, while other hormone levels typically remain normal unless secondary causes are present.
  • Surgical intervention is reserved for cases with confirmed cerebrospinal fluid rhinorrhea (nose leaks), which occurs in less than 10% of patients and requires endoscopic repair.

Empty Sella Syndrome (ESS) is a rare condition where the pituitary gland, a small structure at the base of the brain that controls hormones, is flattened due to the buildup of spinal fluid in the sella turcica, the bony cavity that holds the pituitary gland. This can occur due to the shape of the sella turcica or as a result of surgery, radiation, or head injury.

Types of Empty Sella Syndrome

  • Primary ESS: Occurs when the sella turcica is shaped in a way that allows spinal fluid to leak into it, flattening the pituitary gland.

  • Secondary ESS: Occurs when the pituitary gland is flattened or small due to surgery, radiation for a tumor, or a serious head injury.

Risk Factors for Empty Sella Syndrome

ESS is more common in women than men and is also more likely to occur in people who are obese or have high blood pressure. However, most people with ESS do not experience any symptoms or health problems as a result of the condition.

Understanding Empty Sella Syndrome: Causes, Symptoms, and Treatment Options

Symptoms of Empty Sella Syndrome

While most people with ESS do not experience symptoms, some may develop the following:

  • Headaches

  • High blood pressure

  • Fatigue

  • Impotence (in men)

  • Low sex drive

  • Irregular or absent menstrual periods (in women)

  • Infertility

Less common symptoms may include a feeling of pressure inside the skull, spinal fluid leaking from the nose, swelling in the eyes, and blurry vision.

Diagnosing Empty Sella Syndrome

ESS is usually discovered when doctors are investigating the cause of other health problems. If you have symptoms of ESS, your doctor may recommend imaging tests such as:

  • Magnetic Resonance Imaging (MRI) scan: Uses powerful magnets and radio waves to create detailed images of the brain.

  • Computerized Tomography (CT) scan: Uses X-rays taken from multiple angles to create a comprehensive picture of the head.

Treatment Options for Empty Sella Syndrome

If ESS is not causing any symptoms or health issues, treatment may not be necessary. However, if symptoms are present, your doctor may recommend:

  • Medication: If the pituitary gland is not producing the correct levels of hormones, your doctor may prescribe medications to help regulate hormone production.

  • Surgery: In cases where spinal fluid is leaking from the nose, surgery may be performed to prevent further leakage.

If you suspect you may have Empty Sella Syndrome or are experiencing symptoms, consult your healthcare provider for a proper diagnosis and treatment plan. While ESS is rare, it is essential to address any concerns related to your pituitary gland and overall health.

For more information on Empty Sella Syndrome and other pituitary disorders, visit:

The Bottom Line

This benign condition rarely requires treatment since most people experience no symptoms and maintain normal hormone function throughout their lives. Regular monitoring is only necessary if you develop persistent headaches, vision changes, or signs of hormone deficiency. If you're experiencing unexplained fatigue or hormonal symptoms, Doctronic can help you determine if further evaluation is needed.

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