Intrasellar subarachnoid herniation or empty sella associated with galactorrhea

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Galactorrhea, the abnormal production of milk, can be associated with various pituitary and hypothalamic disorders.
• Empty sella, characterized by the pituitary gland appearing flattened within the sella turcica, is a less common finding.

Purpose of the Study:

• To investigate the association between empty sella and galactorrhea.
• To explore potential mechanisms linking these two conditions.

Main Methods:

• Retrospective review of 115 patients diagnosed with empty sella.
• Detailed analysis of patients presenting with concurrent galactorrhea, including endocrine evaluation and polytome pneumoencephalography.

Main Results:

• Eight out of 115 patients with empty sella also presented with galactorrhea.
• All 8 patients had abnormal sella morphology confirmed by polytome pneumoencephalography.
• Two patients exhibited elevated prolactin levels; no other significant endocrine dysfunctions were noted.
• Hypothalamic and/or pituitary stalk compression was suggested as a potential mechanism for galactorrhea in these cases.

Conclusions:

• A potential association exists between empty sella and galactorrhea, which may be more prevalent than previously recognized.
• Compression of the pituitary stalk or hypothalamus could be a contributing factor to galactorrhea in patients with empty sella.
• Polytome pneumoencephalography is recommended for evaluating patients with galactorrhea and abnormal sella findings.