The empty sella.

Area of Science:

• Neuroendocrinology
• Radiology
• Pituitary Disorders

Background:

• Empty sella (ES) is defined as herniation of the subarachnoid space into the pituitary fossa via an incompetent sellar diaphragm.
• It can be a primary condition or secondary to pituitary disorders, with unclear multifactorial pathogenesis.
• Pediatric and adult etiologies may differ, and ES is often associated with pituitary disorders.

Purpose of the Study:

• To highlight the clinical significance of empty sella.
• To emphasize the need for comprehensive patient evaluation and monitoring.
• To underscore that ES is not merely an incidental finding.

Main Methods:

• Review of clinical manifestations and endocrine abnormalities associated with ES.
• Discussion of diagnostic considerations including endocrine, neurologic, and ophthalmologic evaluations.
• Emphasis on individualized treatment strategies based on patient presentation.

Main Results:

• Empty sella presents with a wide spectrum of clinical features, ranging from asymptomatic cases to severe conditions like panhypopituitarism and visual disturbances.
• Patients require thorough endocrine, neurologic, and ophthalmologic assessments.
• Monitoring and treatment plans must be tailored to individual patient findings.

Conclusions:

• Empty sella necessitates comprehensive evaluation and individualized management.
• Clinicians must recognize the diverse presentations and potential complications of ES.
• ES should not be overlooked as an incidental radiological finding.