Empty Sella Syndrome: A Case Report and Literature Review

Kiran Kumar^1*, Mohammed Khalid¹, Alyaa Fadhil², Pankaj Lamba³, Shaikh Altaf Basha¹, Salwa Abd El Zaher Mabrouk Ibrahim¹

¹Department of Internal Medicine, GMCH & RC, Ajman, UAE.
²Department of Ophthalmology, GMCH & RC, Ajman, UAE.
³Department of Ophthalmology, GMCH & RC, Ajman, UAE.

DOI: 10.4236/nm.2015.61007                

Abstract

An empty sella occurs due to herniation of the arachnoid through an incompetent diaphragma sellae. Over time, cerebrospinal fluid (CSF) pulsations may enlarge the sella and compress the gland against the floor of the sella. Empty sella syndrome is considered as a less common entity and is usually asymptomatic and an incidental finding. However, it can be a manifestation of increased intracranial pressure and can be occasionally severe. Compression of the pituitary gland may affect function, or traction on the optic chiasm and nerves may cause visual symptoms. An empty sella may be classified as primary when this occurs in persons who have not received pituitary radiation or pituitary surgery, while an empty sella discovered following such procedures is classified as secondary empty sella. In this report, we presented a 41-year-old multiparous patient who presented to us with symptoms of headache and left sided hemi-sensory disturbance. Examination was unrevealing except for the fact that she was obese. On evaluation, she was detected to have impaired blood sugars, dyslipidemia and vitamin insufficiency. MRI brain revealed presence of Empty Sella. Further hormonal analysis was normal. She was treated conservatively and regular follow-up was advised.

Keywords

Empty Sella Syndrome, Empty Sella, Pituitary Dysfunction

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Braatvedt, G.D. and Corral, R.J. (1992) The Empty Sella Syndrome: Much Do about Nothing. British Journal of Hospital Medicine, 47, 523-525.
[2]	Sander, E.C. and Peter Jr., W.C. (1996) Empty Sella Syndrome. In: Wilkins, R. and Rengachery, S., Eds., Neurosurgery, McGraw-Hill, New York, 1367-1373.
[3]	Olson, D.R., Guiot, G. and Dereme, P. (1972) The Symptomatic Empty Sella: Prevention and Correction via the Transsphenoidal Approach. Journal of Neurosurgery, 37, 533-537. http://dx.doi.org/10.3171/jns.1972.37.5.0533
[4]	Arlot, S., Lalau, J.D., Galibert, P., et al. (1985) Primary Empty Sella Turcica. Analysis of 14 Cases and Review of Literature. Ann Endocrinol (Paris), 46, 99-105.
[5]	Degli, U.E.C., Teodori, V., Trasforini, G., et al. (1989) The Empty Sella Syndrome. Clinical, Radiological and Endocrinologic Analysis in 20 Cases. Minerva Endocrinologica, 14, 1-18.
[6]	Bragagni, G., Bianconcini, G., Mazzali, F., et al. (1995) 43 Cases of Primary Empty Sella Syndrome: A Case Series. Ann Ital Med Int, 10, 138-142.
[7]	Ghatnatti, V., Sarma, D. and Saikia, U. (2012) Empty Sella Syndrome—Beyond Being an Incidental Finding. Indian Journal of Endocrinology and Metabolism, 16, S321-S323.
[8]	De Marinis, L., Bonadonna, S., Bianchi, A., Maira, G. and Giustina, A. (2005) Primary Empty Sella. Journal of Clinical Endocrinology & Metabolism, 90, 5471-5477. http://dx.doi.org/10.1210/jc.2005-0288
[9]	Fouad, W. (2011) Review of Empty Sella Syndrome and Its Surgical Management. Alexandria Journal of Medicine, 47, 139-147. http://dx.doi.org/10.1016/j.ajme.2011.06.005