Learn About Empty Sella Syndrome

What is the definition of Empty Sella Syndrome?

Empty sella syndrome is a condition in which the pituitary gland shrinks or becomes flattened.

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What are the alternative names for Empty Sella Syndrome?

Pituitary - empty sella syndrome; Partial empty sella

What are the causes of Empty Sella Syndrome?

The pituitary is a small gland located just underneath the brain. It is attached to the bottom of the brain by the pituitary stalk. The pituitary sits protected inside a saddle-like bony compartment in the base of the skull. This compartment is called the sella.

When the pituitary gland shrinks or becomes flattened, it cannot be seen on an MRI scan. This makes the area of the pituitary gland look like an "empty sella." But the sella is not actually empty. It is often filled with cerebrospinal fluid (CSF). CSF is fluid that surrounds the brain and spinal cord. With empty sella syndrome, CSF has leaked into the sella turcica, putting pressure on the pituitary. This causes the gland to shrink or flatten.

Primary empty sella syndrome occurs when one of the layers (arachnoid) covering the outside of the brain bulges down into the sella and presses on the pituitary.

Secondary empty sella syndrome occurs when the sella is empty because the pituitary gland has been damaged by:

  • A tumor
  • Radiation therapy
  • Surgery
  • Trauma

Empty sella syndrome may be seen in a condition called pseudotumor cerebri, which mainly affects young, obese women and causes the CSF to be under higher pressure.

The pituitary gland makes several hormones that control other glands and hormones in the body, including:

  • Adrenal glands
  • Liver hormone related to growth (insulin-like growth factor-1)
  • Ovaries
  • Testicles
  • Thyroid

A problem with the pituitary gland can lead to problems with any of the above glands and abnormal hormone levels of these glands.

What are the symptoms of Empty Sella Syndrome?

Often, there are no symptoms or loss of pituitary function.

If there are symptoms, they may include any of the following:

  • Erection problems
  • Headaches
  • Irregular or absent menstruation
  • Decreased or no desire for sex (low libido)
  • Fatigue, low energy
  • Nipple discharge
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What are the current treatments for Empty Sella Syndrome?

For primary empty sella syndrome:

  • There is no treatment if pituitary function is normal.
  • Medicines may be prescribed to treat any abnormal hormone levels.

For secondary empty sella syndrome, treatment involves replacing the hormones that are missing.

In some cases, surgery is needed to repair the sella to prevent CSF from leaking into the nose and sinuses.

Who are the top Empty Sella Syndrome Local Doctors?
Elite
Highly rated in
31
conditions

Division Of Pediatric Endocrinology

New Delhi, DL, IN 

Deep Dutta is in New Delhi, India. Dutta is rated as an Elite expert by MediFind in the treatment of Empty Sella Syndrome. He is also highly rated in 31 other conditions, according to our data. His top areas of expertise are Empty Sella Syndrome, Hypothyroidism, Type 2 Diabetes T2D, and Maturity Onset Diabetes of the Young.

Distinguished
Highly rated in
25
conditions
Endocrinology

University of California San Francisco Health System

Endocrinology Clinic At Parnassus

400 Parnassus Ave 
San Francisco, CA 94143

Lewis Blevins is an Endocrinologist in San Francisco, California. Dr. Blevins has been practicing medicine for over 35 years and is rated as a Distinguished doctor by MediFind in the treatment of Empty Sella Syndrome. He is also highly rated in 25 other conditions, according to our data. His top areas of expertise are Pituitary Tumor, Hypothalamic Tumor, Prolactinoma, and Panhypopituitarism. He is licensed to treat patients in Tennessee and California. Dr. Blevins is currently accepting new patients.

 
 
 
 
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Distinguished
Highly rated in
50
conditions
Neurosurgery

Jefferson Health

Jefferson University Physicians

1600 Rockland Rd 
Wilmington, DE 19803

James Evans is a Neurosurgery doctor in Wilmington, Delaware. Dr. Evans has been practicing medicine for over 27 years and is rated as a Distinguished doctor by MediFind in the treatment of Empty Sella Syndrome. He is also highly rated in 50 other conditions, according to our data. His top areas of expertise are Meningioma, Craniopharyngioma, Prolactinoma, and Pituitary Tumor. He is licensed to treat patients in Pennsylvania and Delaware. Dr. Evans is currently accepting new patients.

What is the outlook (prognosis) for Empty Sella Syndrome?

Primary empty sella syndrome does not cause health problems, and it does not affect life expectancy.

What are the possible complications of Empty Sella Syndrome?

Complications of primary empty sella syndrome include a slightly higher than normal level of prolactin. This is a hormone made by the pituitary gland. Prolactin stimulates breast development and milk production in women.

Complications of secondary empty sella syndrome are related to the cause of pituitary gland disease or to the effects of too little pituitary hormone (hypopituitarism).

When should I contact a medical professional for Empty Sella Syndrome?

Contact your provider if you develop symptoms of abnormal pituitary function, such as menstrual cycle problems or impotence.

The pituitary gland
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What are the Latest Advances for Empty Sella Syndrome?
Misleading normal TSH and persistently elevated creatine kinase: clues to the diagnosis of chronic Sheehan's syndrome.
Empty sella syndrome: Multiple endocrine disorders.
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Panhypopituitarism in acute myocardial infarction.
Who are the sources who wrote this article ?

Published Date : May 13, 2021
Published By : Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Gleeson H, Reddy N, Levy MJ. Endocrinology. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 21.

Kaiser U, Ho K. Pituitary physiology and diagnostic evaluation. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 8.

Maya M, Pressman BD. Pituitary imaging. In: Melmed S, ed. The Pituitary. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Weiss RE. Anterior pituitary. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 211.