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Empty Sella Syndrome, Causes, Diagnosis, Treatment, Prevention, Complications

Empty sella syndrome is a rare disease that occurs when the pituitary gland in the brain is compressed or compressed. Empty sella syndrome can occur because the cavity where the pituitary gland is filled with cerebrospinal fluid due to birth defects. This condition can also occur as a result of an injury, tumor, or brain hemorrhage. 

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Empty Sella Syndrome, Causes, Diagnosis, Treatment, Prevention, Complications

The pituitary gland is a small organ under the brain and is protected in a cavity in the brain called the sella turcica. This gland plays a role in producing hormones that regulate many body organ functions, such as growth hormone (growth hormone), as well as hormones that produce sperm cells and egg cells.

In certain cases, the cavity where the pituitary gland can be filled with cerebrospinal fluid and causes pressure on the pituitary gland, causing the sella turcica to appear empty. This condition is the reason why this disease is called empty sella syndrome. Empty sella syndrome, also known as arachnoidele, often causes no symptoms. Even so, sufferers can experience many complaints if this disease affects the function of hormones in the body.

Causes of Empty Sella Syndrome


Empty sella syndrome is divided into primary and secondary. Here is the explanation:

Primary empty sella syndrome

Empty sella syndrome is caused by structural abnormalities of the sella turcica present at birth. This condition causes cerebrospinal fluid to leak and fill the pouch and put pressure on the pituitary gland. The cause of the congenital equipment in the cavity is still not known with certainty.

Secondary empty sella syndrome

Secondary empty sella syndrome occurs due to several conditions or diseases that can cause disturbances in the pituitary gland or sella turcica, including:

  • Tumor brain
  • Radiation therapy or surgery around the pituitary gland
  • Increased pressure inside the brain (intracranial hypertension)
  • Pituitary gland tumor
  • Head injury or brain injury
  • Damage to the pituitary gland due to complications during childbirth (Sheehan's syndrome)


Symptoms of Empty Sella Syndrome


Empty sella syndrome is often asymptomatic. If symptoms arise, people with empty sella syndrome can experience complaints in the form of:

  • Erectile dysfunction
  • Decreased sex drive
  • Easily tired
  • Irregular or stopping menstruation (amenorrhea)
  • Galactorrhea, namely the discharge of breast milk or fluid resembling breast milk from the nipples even though you are not pregnant or breastfeeding
  • Increased pressure in the brain
  • Cerebrospinal fluid discharge from the nose
  • Headache
  • Papilledema, which is visual disturbances caused by swelling of the eye nerves due to pressure in the brain

When to see a doctor

Empy sella syndrome is a rare disease and the symptoms it causes are not typical. Therefore, it is unlikely that the patient will be diagnosed with this disease.

However, do a doctor's examination if you experience the symptoms mentioned above. The doctor will carry out a complete examination to find out the cause of the complaint so that it can be handled appropriately.

Diagnosis of Empty Sella Syndrome


First of all, the doctor will conduct questions and answers about the complaints experienced, sexual life, medical history, including head injuries and history of head surgery.

To confirm the diagnosis, the doctor will carry out supporting examinations in the form of:

  • CT scan of the head, to see the condition of the inside of the brain, including where the pituitary gland is
  • MRI of the head, to see a pituitary gland that appears flat, reduced, or even missing, in empty sella syndrome
  • Blood tests, to check the levels of hormones in the blood


Treatment of Empty Sella Syndrome


Although the pituitary gland shrinks as a result of empty sella syndrome, it can still function normally in most sufferers. In this condition, patients with empty sella syndrome do not require special treatment.

If empty sella syndrome affects the function of hormones in the body, the doctor will prescribe hormone replacement drugs. Doctors can also perform surgery if empty sella syndrome causes brain fluid to seep into the nose.

Empty Sella syndrome complications

Empty sella syndrome that is not handled properly can cause complications in the form of:

  • Hypopituitarism, which is a disease caused by a lack of hormones produced by the pituitary gland
  • Cushing's syndrome, which is a variety of symptoms that arise due to too high levels of the hormone cortisol

Prevention of Empty Sella Syndrome

Primary empty sella syndrome cannot be prevented, because the cause is unknown. Meanwhile, secondary empty sella syndrome can be prevented by taking the following steps:

  • Be careful and wear safety equipment when driving, such as a helmet or seat belt
  • Wear proper PPE, especially when working in building construction
  • Install handrails in the bathroom to reduce the risk of slipping
  • Avoid exposure to hazardous chemicals
  • Do not smoke
  • Undergo genetic screening for those who have a history of brain tumors or cancer, to prevent brain tumors that lead to empty sella syndrome

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