Empty Sella Syndrome

Empty sel la refers to the radiological appearance of an enlarged or deformed sella turcica that is partially or completely filled with cerebrospinal fluid. In the earlier days, the radiographic appearance of an enlarged sella turcica was frequently equated with the presence of an intra or perisellar neoplasm. It was found, however, in some of these patients on pneumoencephalography, that the enlarged sella was not occupied by a tumour mass, but a significant amount of air was reaching the sella indicating that the subarachnoid space was extending well below the clinoid processes. To describe this finding, several different terms were used such as intrasellar arachnoid diverticulum, intrasellar cysts, deficient sellar diaphragm, intrasellar cistern1. Busch2, while reporting the presence of empty sella in 5% of normal subjects on autopsy studies, used the term “empty sella” to describe this condition. However, the term empty sella in fact, is a misnomer as the sella is not completely empty, but the pituitary is always present both anatomically and functionally, though often it is displaced downwards and compressed by CSF pressure. An empty sella thus is usually an incidental anatomic finding and occasionally it results in abnormal pitui tary function. Regardless of the size, the sella is completely or partially filled with CSF. It can occur at any age and in either sex. However, it is more common in women and increases in frequency with age3. Definition