What does a partially empty sella mean?

Partially empty sella is actually a medical term, which generally refers to the enlargement of the sella turcica. The causes of empty sella turcica are generally divided into primary and secondary. If the sella turcica is asymptomatic, no treatment is required. Just pay more attention to observation and regular check-ups. If there are obvious sella turcica symptoms, such as headaches and decreased vision, surgical treatment can be chosen when conservative treatment is ineffective.

Empty sella means that in a normal person, the pituitary gland is located in the sella, covered by the septum sellae, with a hole in the center through which the pedicle passes. Therefore, the normal sella is filled with the pituitary gland, without arachnoid membrane and cerebrospinal fluid. However, in some people, the pituitary tissue in the sella turcica cavity is reduced in size, and most of it is occupied by a "vesicle". This condition is called "empty sella" syndrome. It is more common in women (about 90%), especially middle-aged and obese multiparous women. Headache is the most common symptom, sometimes severe but lacking in characteristic features, and mild to moderate hypertension may occur. A small number of patients have decreased vision and visual field defects, which may present as centripetal constriction or temporal hemianopsia. A small number of patients have benign intracranial hypertension (pseudotumor cerebri), which may be accompanied by papilledema and increased cerebrospinal fluid pressure. Some patients have cerebrospinal fluid rhinorrhea, which may be caused by a transient increase in cerebrospinal fluid pressure, causing the opening of the channel left over from the embryonic period between the sella turcica and the oral cavity. A small number of patients have hypopituitarism, which may present with mild hypogonadism and hypothyroidism, and hyperprolactinemia. The function of the posterior pituitary gland is generally normal, but diabetes insipidus may occur in some children. Children may be accompanied by skeletal dysplasia syndrome.

Causes of empty sella

One is that the central hole is congenitally large, and under the pressure of cerebrospinal fluid, the subarachnoid herniation into the sella turcica gradually expands into a cystic shape, squeezing the pituitary tissue to shrink and occupy the sella turcica;

The second is that some physiological or pathological endocrine changes cause the pituitary tissue to swell and enlarge temporarily, and the holes in the sellar diaphragm also enlarge. Afterwards, the pituitary returns to its normal size, which also causes an empty sella.

Thirdly, local infection and trauma in the sella turcica area may cause arachnoid adhesion, which leads to increased cerebrospinal fluid pressure and causes the arachnoid membrane to herniate into the sella turcica. Finally, the sella turcica may be empty after surgical removal of the pituitary tumor or radiotherapy, so the arachnoid membrane herniates into the sella turcica and causes empty sella syndrome.