Empty sella in children as a key for diagnosis

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Endocrinology

Background:

• The empty sella is a common finding in adults, but its prevalence and significance in children are less understood.
• Idiopathic intracranial hypertension (IIH) and nevoid basal cell carcinoma syndrome (NBCCS) are rare pediatric conditions with potential neurological and endocrine manifestations.

Purpose of the Study:

• To investigate the prevalence of empty sella in a pediatric population undergoing pituitary MRI.
• To determine the association between empty sella and specific pediatric conditions, particularly IIH and NBCCS.

Main Methods:

• Retrospective analysis of 354 children who underwent pituitary MRI.
• Review of clinical data, hormonal results, and diagnoses for children with empty sella.
• Statistical analysis to assess the significance of empty sella frequency in specific conditions.

Main Results:

• An empty sella was identified in 11 out of 354 children (3.1%), all with normal hormonal profiles.
• A significantly high frequency of empty sella was observed in children with IIH (4/4) and NBCCS (3/5).
• The estimated prevalence of empty sella in children, excluding IIH and NBCCS, was 1.2%, considerably lower than in adults.

Conclusions:

• Pituitary MRI in children can reveal an empty sella, which is uncommon but warrants further investigation.
• The high association of empty sella with IIH and NBCCS suggests its utility as a potential diagnostic clue for these syndromes in pediatric patients.
• Further research is needed to elucidate the specific mechanisms linking empty sella to these pediatric conditions.