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Related Experiment Videos

[Primary empty sella syndrome. Observations on 71 cases].

G Bianconcini1, G Bragagni, M Bianconcini

  • 1Sezione di Medicina Interna, Casa di Cura Policlinica Villa Verde, Reggio Emilia.

Recenti Progressi in Medicina
|April 20, 1999
PubMed
Summary

Primary empty sella syndrome (ESS) is characterized by pituitary compression. This study found ESS frequently associated with mental disorders, obesity, and hypertension, suggesting a potential hypothalamic origin.

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Area of Science:

  • Neuroendocrinology
  • Radiology
  • Internal Medicine

Background:

  • Primary empty sella syndrome (ESS) is an anatomical condition where cerebrospinal fluid fills the sella turcica, compressing the pituitary gland.
  • ESS is often observed in women with obesity and hypertension and can be asymptomatic or present with various neurological and endocrine issues.

Purpose of the Study:

  • To investigate the clinical, radiological, and endocrinological profiles of patients with primary ESS.
  • To identify potential associations and underlying mechanisms, particularly focusing on mental health and hypothalamic dysfunction.

Main Methods:

  • Retrospective analysis of 71 primary ESS cases over 14 years.
  • Comprehensive endocrinological assessments including hormonal profiles, provocative, and inhibition tests.

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  • Clinical evaluations encompassing neurological, ophthalmological, and radiological (CT/MRI) assessments.

    • Main Results:

    • High prevalence of headaches (73.2%), hypertension (59.1%), and obesity (66.1%) in ESS patients.
    • Significant association with mental disorders (80.2%), including anxiety and dysthymia with behavioral disturbances, a finding not previously highlighted.
    • Endocrinopathies detected in 50.7% of cases, with hypopituitarism and growth hormone deficiency being notable.

    Conclusions:

    • Primary ESS is frequently linked to mental health disturbances and obesity, suggesting a broader hypothalamic involvement.
    • The study proposes ESS as a potential "new" hypothalamic syndrome due to compression/stretching of the pituitary stalk and associated neurochemical imbalances.
    • Further research into the neuroendocrine and neurotransmitter dysregulation in ESS is warranted.