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Empty Sella Syndrome

Michael Sorrenti, MD, Angela Pauline Patawaran Calimag, MAN, RN, BSN, MD and Armand Krikorian, FACP, FACE, MD, MBA Reviewed 06/2021
 


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 (7).

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

  • Infertility

  • CSF rhino...

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...

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
Auer MK, Stieg MR, Crispin A, et al. Primary empty sella syndrome and the prevalence of hormonal dysregulation: a systematic review. Dtsch Ärztebl Int. 2018Feb;115(7):99.
2
...

CODES

ICD10

E23.6 Other disorders of pituitary gland 

SNOMED

  • 237722004 Empty sella syndrome

  • 91187007 pituitary dwarfism with small sella turcica (disorder)

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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