What is Empty Sella in Brain?
The term “empty sella” refers to a condition where the sella turcica, a saddle-shaped bone at the base of the skull that houses the pituitary gland, becomes underfilled with cerebrospinal fluid (CSF). This results in a space within the sella that appears empty on imaging studies, such as magnetic resonance imaging (MRI) scans. While the term “empty” might suggest a lack of substance, it’s important to note that the pituitary gland itself remains intact and functional in most cases. Understanding the causes, symptoms, and treatment options for empty sella is crucial for those affected by this condition. In this article, we will delve into the details of empty sella in the brain, exploring its origins, implications, and management strategies.
The sella turcica is a crucial anatomical structure as it provides a protective space for the pituitary gland, which is responsible for producing and releasing hormones that regulate various bodily functions. Normally, the sella turcica is filled with CSF, a clear fluid that surrounds and cushions the brain and spinal cord. However, in the case of an empty sella, the CSF fills the space around the pituitary gland but does not infiltrate the gland itself.
Causes of Empty Sella
The exact cause of empty sella is often unknown, but several factors may contribute to its development. One of the most common causes is the stretching of the sellar floor as a result of increased intracranial pressure. This stretching can occur due to a variety of reasons, including:
1. Head trauma: A blow to the head can cause the sellar floor to become stretched and allow CSF to enter the space.
2. Pituitary adenoma: A benign tumor that grows on the pituitary gland can cause the gland to swell and push against the sella turcica, leading to stretching and CSF accumulation.
3. Pituitary surgery: Surgery to remove a pituitary tumor or to treat other pituitary disorders can result in stretching of the sella turcica.
4. Head injury: Trauma to the head can lead to bleeding and swelling, which may cause CSF to accumulate in the sella turcica.
5. Inflammation: Conditions such as sarcoidosis or tuberculosis can cause inflammation around the sella turcica, leading to stretching and CSF accumulation.
Symptoms and Diagnosis
In many cases, an empty sella does not cause any symptoms and is discovered incidentally during an MRI scan performed for another reason. However, when symptoms do occur, they may include:
1. Headaches: Pressure on the surrounding structures can lead to headaches, which may be worse when standing up or lying down.
2. Visual disturbances: Pressure on the optic nerves can cause blurred vision, double vision, or even loss of peripheral vision.
3. Hormonal imbalances: If the pituitary gland is affected, it may not produce adequate hormones, leading to symptoms such as fatigue, weight gain, or changes in mood.
To diagnose an empty sella, a healthcare provider will typically perform an MRI scan of the brain. The scan will reveal the characteristic empty space within the sella turcica, allowing for a definitive diagnosis.
Treatment and Management
The treatment for an empty sella depends on the presence of symptoms and the extent of the condition. In many cases, no treatment is necessary, as the condition is benign and does not typically worsen over time. However, if symptoms are present, treatment options may include:
1. Medications: Medications may be prescribed to manage symptoms such as headaches or hormonal imbalances.
2. Steroids: In some cases, corticosteroids may be used to reduce inflammation and alleviate symptoms.
3. Surgery: In rare instances, surgery may be necessary to relieve pressure on surrounding structures or to correct the stretching of the sella turcica. This may involve removing a portion of the sellar floor or repairing the stretched area.
In conclusion, an empty sella is a condition where the sella turcica becomes underfilled with cerebrospinal fluid, resulting in an empty space on imaging studies. While the condition may not always cause symptoms, it is important to understand its potential implications and treatment options. With proper management, individuals with an empty sella can lead healthy, fulfilling lives.
