What causes Empty Sella in the pituitary gland on MRI or CT?
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Answer:
Empty sella refers to an enlarged sella turcica filled with cerebrospinal fluid (CSF) resulting in a flattened pituitary gland along the sellar floor, seen in primary empty sella syndrome due to idiopathic CSF herniation or secondary causes including idiopathic intracranial hypertension, post-pituitary surgery, radiation, trauma, or tumor regression.
Why is it called so?
It is named “empty sella” because the sella turcica appears partially or completely devoid of the pituitary gland on imaging, creating an illusory empty appearance despite being filled with CSF and a compressed or flattened gland.
Pathophysiology
CSF herniates into the sella turcica through a defective diaphragma sellae or due to elevated intracranial pressure, exerting chronic pulsatile pressure that flattens the pituitary gland inferiorly against the sellar floor and may remodel the bony sella through expansion.
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