The pituitary gland is housed by the sella turcica, which lies inferior to the frontal lobe of the brain, and anterior to the fourth ventricle and pons. The darkest area in this MRI image just under the frontal lobe, surrounds the sella turcica which is outlined in white and looks like an incomplete circle. Inside the sella turcica is the pituitary gland, only in this case the sella turcica is filled with CSF or cerebral spinal fluid. This CSF has flattened the pituitary gland and this flattening of the pituitary gland gives the appearance of an empty sella turcica, thus the name, empty sella syndrome.
There is primary and secondary ESS.
Primary ESS is the increased pressure of CSF flattening out the pituitary gland along the interior walls of the sella turcica. Primary ESS related to obesity as well as high blood pressure in women, and can cause a build up of fluid pressure in the skull.
In secondary ESS, the pituitary gland becomes smaller, shrinking inside the Sella turcica due to some sort of injury or related surgery, and or radiation therapy. Due to an improperly functioning pituitary gland, a ceasing of menstrual periods, infertility, fatigue as well an intolerance to stress and infection may occur.
ESS in children may cause an early onset of puberty, and a low growth rate due to a deficiency in producing growth hormones.
MRI scans may be the modality of choice in evaluating ESS.
Typically, ESS is not a life threatening disorder.
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