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Empty sella syndrome: does it exist in children?
A Ammar1, A Al-Sultan, F Al Mulhim
1Department of Neurosurgery, King Fahd University Hospital, Al Khobar, Saudi Arabia. ammar99@soficom.com.eg
Journal of Neurosurgery
|December 10, 1999
Summary
Empty sella syndrome (ESS) affects children, often presenting with headaches and growth issues. Early diagnosis and treatment are crucial to prevent serious neurological complications in pediatric patients.
Area of Science:
- Pediatric neurosurgery
- Endocrinology
- Radiology
Background:
- Empty sella syndrome (ESS) is a recognized condition in adults, but its occurrence and implications in children are less understood.
- This study aims to increase neurosurgical awareness of ESS in pediatric populations and contribute to existing literature.
Observation:
- Twelve children aged 2-8 years with ESS were analyzed, showing enlarged sella turcica filled with cerebrospinal fluid.
- Causes included high intracranial pressure, hydrocephalus, and arachnoid cysts; primary ESS was also observed.
- Presenting symptoms were headache, underweight status, and short stature, with normal hormone assays.
Findings:
- Neuroradiological studies confirmed cerebrospinal fluid filling the sella turcica with herniation of suprasellar and arachnoid spaces.
- Common clinical manifestations in children include headaches, abnormal body weight, and short stature.
- Hormonal evaluations were consistently normal across all pediatric cases studied.
Implications:
- Undiagnosed or untreated ESS in children can lead to severe consequences, including pituitary/hypothalamic dysfunction and optic chiasm damage.
- Raising neurosurgical awareness is vital for early diagnosis and timely intervention in pediatric ESS cases.
- A classification system for the diaphragma sellae is presented to aid in understanding and management.