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Empty Sella Syndrome

Michael Sorrenti, MD, Hafsa Amjed, MD and Armand Krikorian, MD, FACE, FACP Reviewed 06/2019
 


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

    • Caber...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • In patients with traumatic brain injury, it is important to monitor pituitary function.

  • Patients found to have hypopituitarism should be monitore...

REFERENCES

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

ADDITIONAL READING

Shaw GY, Million SK. Benign intracranial hypertension: a diagnostic dilemma. Case Rep Otolaryngol.  2012;2012:814696. [View Abstract on OvidMedline] 

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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