Empty sella syndrome

In empty sella syndrome (ESS), the pituitary gland shrinks or becomes flattened, filling the sella turcica with cerebrospinal fluid on imaging instead of the normal pituitary. The reported prevalence of primary empty sella in general population is 8–35 %, with a higher incidence in females, the ratio being 5:1. It is generally found in middle aged women who are obese and hypertensive. It is unknown whether this is causal or a consequence of hormonal abnormalities arising from pituitary changes. However, most people with ESS are asymptomatic.

A finding of ESS on an MRI may be an indication of intracranial hypertension, particular if symptoms of intracranial pressure are present.