Primary empty sella syndrome and benign intracranial hypertension

The combination of the empty sella syndrome (ESS) and benign intracranial hypertension (BIH) is illustrated by two case histories. The causal relationship between the ESS and the BIH can be explained by two mechanisms. Raised intracranial pressure could produce a herniation of the subarachnoid cistern into the sella turcica, if the diaphragma sellae is incomplete. Alternatively an infarction in a pituitary adenoma could result in both an ESS and cerebrospinal fluid flow obstruction, which could lead to BIH.