scholarly journals Empty Sella Prevalence: Step By Step

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Victoria B. Sharavii ◽  
Natalya A. Shnayder ◽  
Lada K. Sharavii ◽  
Marina M. Petrova ◽  
Regina F. Nasyrova
Keyword(s):  
Pituitary Gland ◽  
Subarachnoid Space ◽  
Sella Turcica ◽  
Empty Sella ◽  
Systematic Search ◽  
Pituitary Fossa ◽  
The World

An empty sella (ES), also known as an empty sella turcica (empty pituitary fossa) is defined as an intrasellar herniation of subarachnoid space within the sella which leads to flattening of the pituitary gland towards the posteroinferior wall. Purpose — to analyze studies of ES prevalence in the world. Methods — We carried out a systematic search in both Russian and English databases (E-library, PubMed, GoogleScholar, OxfordPress, ClinicalKeys) using keywords “empty sella”, “empty sella turcica”, “empty pituitary fossa”, “prevalence” and their combinations. The period of search: 2000-2020. It is also worth noting that earlier publications of historical interest were included in the review. Results — We have analyzed 23 studies. They can be roughly devided into two groups: the first group – screening studies of ES, the second group – targeted studies of ES.

scholarly journals Enlargement of the sella turcica in pseudotumor cerebri

2014 ◽  
Vol 120 (2) ◽  
pp. 538-542 ◽  
Author(s):  
Sung-eun E. Kyung ◽  
James V. Botelho ◽  
Jonathan C. Horton
Keyword(s):  
Intracranial Pressure ◽  
Pituitary Gland ◽  
Sella Turcica ◽  
Pseudotumor Cerebri ◽  
Empty Sella ◽  
Slight Reduction ◽  
Mr Images ◽  
Pituitary Fossa ◽  
Cross Sectional ◽  
Bony Enlargement

Object The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. Methods The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patients were selected from the same practice. The sella turcica and pituitary gland were measured on sagittal T1-weighted MR images. Results Measurements were obtained for 48 patients with pseudotumor cerebri and 48 controls. The cross-sectional area of the sella was 38% greater in the patients with pseudotumor cerebri, with only a slight reduction in mean pituitary gland size. Conclusions Chronic elevation of intracranial pressure is associated with bony enlargement of the sella turcica. Enlargement of the sella turcica contributes to its partially empty appearance.

scholarly journals Primary Empty Sella Syndrome: A Case Report

1970 ◽  
Vol 1 (1) ◽  
pp. 23-25
Author(s):  
Md Sanwar Hossain ◽  
Mahbuba Ashrafi Mumu ◽  
Md Moyenuddin PK
Keyword(s):  
Case Report ◽  
Pituitary Gland ◽  
Subarachnoid Space ◽  
Empty Sella ◽  
Multiple Pregnancies ◽  
Empty Sella Syndrome ◽  
Ocular Abnormalities ◽  
Medical College ◽  
Persistent Headache ◽  
Primary Empty Sella

Primary Empty Sella Syndrome (PES) is a relatively rare or uncommon developmental disease that develops spontaneously. It is characterized by herniation of subarachnoid space within the sella which is often associated with some degree of flattening of pituitary gland. Usually manifested by endocrine abnormalities, ocular abnormalities, rhinitis and intractable persistent headache. It is higher in obese females having multiple pregnancies. Here we report a case of empty sella syndrome in a 27 year old lady to aware the physicians to bear in mind a differential in patients having persistent intractable headache. Key words: Empty Sella Syndrome; Woman; Obesity; Intractable Headache DOI: 10.3329/akmmcj.v1i1.7456 Anwer Khan Modern Medical College Journal 2010; 1(1): 23-25

CORTICOSTERONE SECRETING ADRENAL CARCINOMA AND EMPTY SELLA TURCICA: A CASE REPORT

1979 ◽  
Vol 91 (4) ◽  
pp. 650-656
Author(s):  
Bjørn Krølner ◽  
Steen Larsen ◽  
Meta Damkjær Nielsen
Keyword(s):  
Sella Turcica ◽  
Pituitary Hormones ◽  
Empty Sella ◽  
High Dose ◽  
Adrenal Carcinoma ◽  
Pituitary Fossa ◽  
High Dose Dexamethasone ◽  
Corticosterone Metabolites ◽  
Steroid Excretion ◽  
Urinary Steroid

ABSTRACT Pituitary adenoma was suspected in a woman of 74 with hypercorticism, hypokalaemic alkalosis and radiographically enlarged sella turcica. However, non-suppressibility of steroid excretion by high-dose dexamethasone and low plasma concentration of ACTH suggested adrenal tumour. Detailed analysis of urinary steroid excretions demonstrated unusually large amounts of corticosterone metabolites, 14.6 mg/24 h compared to a mean normal value of 0.5 mg. The basal levels of the remaining pituitary hormones were unremarkable. The patient died incidentally before a planned adrenalectomy. The autopsy disclosed an adrenal carcinoma and an empty sella turcica. The enlarged pituitary fossa was lined by a narrow rim of histological normal pituitary tissue.

scholarly journals Magnetic Resonance Imaging Features and Clinical Findings in Pediatric Idiopathic Intracranial Hypertension: A Case–Control Study

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 487
Author(s):  
Aubrey L. Gilbert ◽  
Jennifer Vaughn ◽  
Sarah Whitecross ◽  
Caroline D. Robson ◽  
David Zurakowski ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Subarachnoid Space ◽  
Pediatric Patients ◽  
Case Control Study ◽  
Sella Turcica ◽  
Empty Sella ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Dural Venous Sinus ◽  
Control Study

The purpose of this study is to identify salient magnetic resonance imaging (MRI) findings of pediatric IIH, to determine the relevance of these findings with regard to disease pathogenesis, and to relate these findings to the clinical presentation towards identification of risk factors of disease. A retrospective, a case–control study of 38 pediatric patients with and 24 pediatric patients without IIH from the ophthalmology department at a tertiary care center was performed. Clinical data, including ophthalmic findings and lumbar puncture results, were recorded. Neuroimaging, including both MRI and magnetic resonance venography (MRV), was evaluated for perioptic subarachnoid space diameter enlargement, posterior globe flattening, optic nerve head protrusion, empty or partially empty sella turcica, dural venous sinus abnormalities, skull base crowding, and prominent arachnoid granulations. Compared with controls, IIH patients had larger perioptic subarachnoid space diameters, higher incidences of posterior globe flattening, protrusion of the optic nerve heads, an empty sella turcica, and dural venous sinus abnormalities. A perioptic subarachnoid space diameter of ≥5.2 mm was identified as an independent predictor of IIH (p < 0.001) with sensitivity of 87% and specificity of 67%. Several significant MRI findings in pediatric IIH were identified. Using a model that uniquely incorporated clinical and MRI findings at presentation, we provide a framework for risk stratification for the diagnosis of pediatric IIH which may be utilized to facilitate diagnosis. Future prospective work is needed to further validate the model developed in this study.

AYURVEDIC MANAGEMENT OF PARTIAL EMPTY SELLA SYNDROME: A CASE REPORT

2021 ◽  
Vol 12 (4) ◽  
pp. 15-18
Author(s):  
Eswara M P Sarma ◽  
Arathi P K
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Pituitary Gland ◽  
Sella Turcica ◽  
Marked Change ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Lukewarm Water

Empty Sella Syndrome is a disorder that involves the presence of Cerebro-spinal fluid in Sella turcica in an excess amount. In empty Sella syndrome the Sella turcica is either partially filled with cerebrospinal fluid and an atrophied pituitary gland lying in the floor of the Sella (Partial Empty Sella Syndrome) or filled with cerebrospinal fluid which pushes the pituitary gland into a side of Sella turcica resulting in non-visualization of the gland. (Completely empty Sella). A 37-year-old female diagnosed with partial empty Sella syndrome was managed with Pathyakshadhatryadi kashayam 15 ml twice daily in empty stomach with 45 ml lukewarm water, Rasnadi choornam tailam application, mahatraiphala ghritam 10 ml at night after food, Kshirabala 7 Avarti tailam pratimarsha nasyam. After completion of the treatment, there was considerable relief in the primary complaint of the patient which was a recurrent headache and the follow up MRI showed a marked change in the condition. This case report highlights the role of Ayurveda in the management of partial empty Sella syndrome and sheds light for further study on the same.

Reconstruction of the Pituitary Fossa in Transsphenoidal Surgery: An Experience of 140 Cases

Neurosurgery ◽  
1985 ◽  
Vol 17 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Renato Spaziante ◽  
Enrico de Divitiis ◽  
Paolo Cappabianca
Keyword(s):  
Cerebrospinal Fluid ◽  
Transsphenoidal Surgery ◽  
Sella Turcica ◽  
Empty Sella ◽  
Transsphenoidal Approach ◽  
Cerebrospinal Fluid Leakage ◽  
Pituitary Fossa ◽  
Postoperative Course ◽  
Precise Method ◽  
Surgical Condition

Abstract Even though the main problems of transsphenoidal surgery are encountered during the intra- and suprasellar portions of the operation, proper reconstruction of the sella turcica plays an important role in the overall results, greatly influencing the final outcome. Improper measures may bring about a complicated postoperative course, whereas a wise and precise method allows one to control any surgical condition, preventing the more dangerous consequences of the transsphenoidal approach (i.e., empty sella, cerebrospinal fluid leakage, hemorrhage, infection, etc.). The authors review the different methods of sellar plugging and, on the basis of their own experience, indicate the most suitable one for each of the more usual situations. A good result is achievable if only natural materials are used and one avoids synthetic prostheses. Extradural packing is the technique of choice whenever a hermetic closure and a particularly effective intrasellar plug are required.

The Medial Wall of the Cavernous Sinus: Microsurgical Anatomy

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 179-190 ◽  
Author(s):  
Alexandre Yasuda ◽  
Alvaro Campero ◽  
Carolina Martins ◽  
Albert L. Rhoton ◽  
Guilherme C. Ribas
Keyword(s):  
Pituitary Gland ◽  
Cavernous Sinus ◽  
Thin Sheet ◽  
Single Layer ◽  
Lateral Wall ◽  
The Body ◽  
Medial Wall ◽  
Microsurgical Anatomy ◽  
Pituitary Fossa ◽  
Adjacent Structures

Abstract OBJECTIVE: This study was conducted to clarify the boundaries, relationships, and components of the medial wall of the cavernous sinus (CS). METHODS: Forty CSs, examined under ×3 to ×40 magnification, were dissected from lateral to medial in a stepwise fashion to expose the medial wall. Four CSs were dissected starting from the midline to lateral. RESULTS: The medial wall of the CS has two parts: sellar and sphenoidal. The sellar part is a thin sheet that separates the pituitary fossa from the venous spaces in the CS. This part, although thin, provided a barrier without perforations or defects in all cadaveric specimens studied. The sphenoidal part is formed by the dura lining the carotid sulcus on the body of the sphenoid bone. In all of the cadaveric specimens, the medial wall seemed to be formed by a single layer of dura that could not be separated easily into two layers as could the lateral wall. The intracavernous carotid was determined to be in direct contact with the pituitary gland, being separated from it by only the thin sellar part of the medial wall in 52.5% of cases. In 39 of 40 CSs, the venous plexus and spaces in the CS extended into the narrow space between the intracavernous carotid and the dura lining the carotid sulcus, which forms the sphenoidal part of the medial wall. The lateral surface of the pituitary gland was divided axially into superior, middle and inferior thirds. The intracavernous carotid coursed lateral to some part of all the superior, middle, and inferior thirds in 27.5% of the CSs, along the inferior and middle thirds in 32.5%, along only the inferior third in 35%, and below the level of the gland and sellar floor in 5%. In 18 of the 40 CSs, the pituitary gland displaced the sellar part of the medial wall laterally and rested against the intracavernous carotid, and in 6 there was a tongue-like lateral protrusion of the gland that extended around a portion of the wall of the intracavernous carotid. No defects were observed in the sellar part of the medial wall, even in the presence of these protrusions. CONCLUSION: The CS has an identifiable medial wall that separates the CS from the sella and capsule of the pituitary gland. The medial wall has two segments, sellar and sphenoidal, and is formed by just one layer of dura that cannot be separated into two layers as can the lateral wall of the CS. In this study, the relationships between the medial wall and adjacent structures demonstrated a marked variability.

scholarly journals Metastases to the pituitary gland

2004 ◽  
Vol 16 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Daniel R. Fassett ◽  
William T. Couldwell
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Skull Base ◽  
Survival Rates ◽  
Tumor Resection ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Visual Field Defects ◽  
Malignant Neoplasms ◽  
Pituitary Metastases

Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

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