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Empty Sella Syndrome

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Normally, the pituitary gland sits in a small skull compartment at the base of the brain known as the sella turcica (Latin for “Turkish saddle”).

  • In empty sella syndrome (ESS), there ...

DIAGNOSIS

HISTORY

  • The most common complaint is headache (60–80%) with no specific clinical features (5).

  • Menstrual irregularity (has been reported in up to 20% of patients with PES)

  • Infertility

  • CSF rhinor...

TREATMENT

MEDICATION

  • Treat only if there are resultant medical problems (no treatment, if pituitary function is normal). Each endocrine disorder is then addressed individually.

  • Hyperprolactinemia

    • Cabergo...

REFERENCES

1
De Marinis L, Bonadonna S, Bianchi A, et al. Primary empty sella. J Clin Endocrinol Metab.  2005;90(9):5471–5477. {L-End} [View Abstract on OvidMedline]
2
Lubrano C, Tenuta M, Costanti...

ADDITIONAL READING

  • Agrawal NK, Jain P, Garg S. Primary empty sella with isolated ACTH deficiency and microprolactinoma. Gynecol Endocrinol.  2012;28(7):568–569.

  • Del Monte P, Foppiani L, Cafferata ...

CODES

ICD10

E23.6 Other disorders of pituitary gland 

ICD9

253.8 Other disorders of the pituitary and other syndromes of diencephalohypophyseal origin 

SNOMED

  • 237722004 Empty sella syndrome

  • 91187007 pituita...

CLINICAL PEARLS

  • An incidental finding of empty sella on MRI or CT warrants a thorough history and physical exam to evaluate for signs or symptoms of hypopituitarism, with appropriate lab studies.

  • Hypop...

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