Empty Sellar Syndrome

1. PRIMARY EMPTY SELLA
Chiloiro, S., Giampietro, A., Bianchi, A., Tartaglione, T.,
Capobianco, A., Anile, C., & De Marinis, L. (2017).
DIAGNOSIS OF ENDOCRINE DISEASE: Primary empty
sella: a comprehensive review. European journal of
endocrinology, 177(6), R275-R285.
Summarized by: Ade Wijaya, MD – February 2018

2. OUTLINE:
 Introduction
 Epidemiology
 Pathogenesis
 Diagnosis
 Differential Diagnosis
 Treatment
 Summary

3. INTRODUCTION
 Herniation of the subarachnoid space within the
sella, which is often associated with variable degree
of flattening of the pituitary gland.
 Primary vs Secondary
 First coined by Bush in 1951

4. EPIDEMIOLOGY
 8-35 % in general population
 F:M = 5:1
 30-40 years of age
 Present in 70 % patients with IIH

5. PATHOGENESIS

6. DIAGNOSIS

7. DIFFERENTIAL DIAGNOSIS
 Cystic lesions, as arachnoid and epidermoid cysts
 Congenital pituitary anomalies

8. TREATMENT

9. FOLLOW UP
 No symptoms : 24-36 months
 Symptomatic : at least twice a year

10. SUMMARY
 Mostly asymptomatics
 Symptoms: neurology, opthalmology, endocrine
 Multidisciplinary approach