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What Are The Implications Of An Empty Sella On A Scan?

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Posted on Thu, 1 Jun 2017
Question: What is a empty cella and what are the implications?
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Answered by Dr. Bonnie Berger-Durnbaugh (57 minutes later)
Brief Answer:
Empty Sella Syndrome

Detailed Answer:
Hello and welcome,

Empty Sella is when, on an MRI or CT, a part of the brain called the Sella Turcica, which houses the pituitary gland, is filled with cerebrospinal fluid and the pituitary isn't seen.

This can happen when a small defect above the pituitary gland causes increased pressure in the sella turcica and causes the pituitary gland to pushed to one side and flatten out. In some cases when this happens, there can be increased intracranial pressure, but if that wasn't noted on the MRI, then it may not be happening. This cause of Empty Sella is often associated with obesity or pregnancy.

Empty sella syndrome can also happen as a result of brain injury, radiation, or brain surgery which causes some destruction to the pituitary gland.

But in most cases, Empty Sella Syndrome is just an incidental finding on radiology tests and doesn't mean there isn't a pituitary gland or that it isn't working. And in these incidental findings, there often aren't symptoms.

Symptoms of Empty Sella, when they occur, are usually headaches (better when lying down) or visual problems.

Treatment, if the pituitary isn't working well, is usually supportive, meaning if there are abnormalities because of this, they are treated. For example, if the pituitary is not functioning adequately, it can lead to the adrenal gland making less cortisol, so in periods of stress (usually physical), additional cortisol should be given if needed. If the cause of the Empty Sella Syndrome is from excessive cerebrospinal fluid, then that is drained.

I don't know what the reason was that you had a brain MRI, but if you have no hormonal abnormalities, and are not having headaches or significant eye problems, and they noted no increased intracranial pressure on the MRI, then likely your falls in the "incidental findings" category.

I recommend you talk further with the doctor who ordered your MRI regarding what the significance of Empty Sella might be for your particular situation.

I am attaching some information you might find helpful. Unfortunately it will not show up as a blue link. To see the article, you will need to copy and paste it into your address bar. Here it is:

http://pituitary.org/knowledge-base/disorders/empty-sella-syndrome

I hope this information helps.

So...no worries if you aren't having symptoms, but do discuss the findings with your doctor.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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What Are The Implications Of An Empty Sella On A Scan?

Brief Answer: Empty Sella Syndrome Detailed Answer: Hello and welcome, Empty Sella is when, on an MRI or CT, a part of the brain called the Sella Turcica, which houses the pituitary gland, is filled with cerebrospinal fluid and the pituitary isn't seen. This can happen when a small defect above the pituitary gland causes increased pressure in the sella turcica and causes the pituitary gland to pushed to one side and flatten out. In some cases when this happens, there can be increased intracranial pressure, but if that wasn't noted on the MRI, then it may not be happening. This cause of Empty Sella is often associated with obesity or pregnancy. Empty sella syndrome can also happen as a result of brain injury, radiation, or brain surgery which causes some destruction to the pituitary gland. But in most cases, Empty Sella Syndrome is just an incidental finding on radiology tests and doesn't mean there isn't a pituitary gland or that it isn't working. And in these incidental findings, there often aren't symptoms. Symptoms of Empty Sella, when they occur, are usually headaches (better when lying down) or visual problems. Treatment, if the pituitary isn't working well, is usually supportive, meaning if there are abnormalities because of this, they are treated. For example, if the pituitary is not functioning adequately, it can lead to the adrenal gland making less cortisol, so in periods of stress (usually physical), additional cortisol should be given if needed. If the cause of the Empty Sella Syndrome is from excessive cerebrospinal fluid, then that is drained. I don't know what the reason was that you had a brain MRI, but if you have no hormonal abnormalities, and are not having headaches or significant eye problems, and they noted no increased intracranial pressure on the MRI, then likely your falls in the "incidental findings" category. I recommend you talk further with the doctor who ordered your MRI regarding what the significance of Empty Sella might be for your particular situation. I am attaching some information you might find helpful. Unfortunately it will not show up as a blue link. To see the article, you will need to copy and paste it into your address bar. Here it is: http://pituitary.org/knowledge-base/disorders/empty-sella-syndrome I hope this information helps. So...no worries if you aren't having symptoms, but do discuss the findings with your doctor.