The Empty Sella Syndrome

Abstract

The term empty sella syndrome denotes the presence of an enlarged sella turcica containing a remodeled pituitary gland flattened against the posterior and inferior walls of the sella. The term “empty” is somewhat of a misnomer, since the sella is filled partially by the remodeled flat pituitary gland and partially by cerebrospinal fluid. The condition is a result of extension of the subarachnoid space into the sella as a result of incompleteness in the diaphragma sella. This weakness in the diaphragma sella, which is probably congenital, allows the extension of a small arachnoid diverticulum, filled with CSF, into the sella. The diverticulum enlarges slowly and gradually pushes the normal pituitary gland against the posterior and inferior wall. In chronic cases, the walls of the sella expand to accommodate the enlarged arachnoid diverticulum.