Empty Sella Syndrome (ESS) is a disease that involves an enlarged sella turcica and in turn affects the pituitary gland and its functions. It is important to note that the pituitary gland itself is usually of normal size although it may be slightly smaller. Primary ESS occurs most often in obese women and women with high blood pressure. This form of ESS is caused by an anatomical defect that is superior to the pituitary gland and puts pressure along the sella turcica in turn squashing the pituitary along the walls of the sella turcica. This also involves a problem in the barrier that separates the sella turcica from the CSF around the brain. When these patients have ESS, the sella turcica will fill up with CSF causing it to look empty. Secondary ESS is caused by a complication of injury, surgery or radiation therapy. In this case, the pituitary gland shrinks within the sella turcica. Secondary ESS symptoms often include amenorrhea, infertility, and overall fatigue while primary ESS causes headaches and vision problems. In rare cases, CSF can leak from the nose or the patient will experience a chronic runny nose. Most often ESS is diagnosed on accident with the patient experiencing no symptoms. Patients presenting with symptoms will be tested with either a CT or MRI. Most often a pituitary function test is run in order to rule out any other hormone excess of deficiency. Most symptoms of ESS are mild and usually do not require any type of treatment. In more severe cases surgery can be done to reduce the pressure put on the sella turcica. More information on ESS can be found at the following websites:
http://www.healthsystem.virginia.edu/uvahealth/adult_endocrin/sella.cfm
http://www.medic8.com/neurological-disorders/emptysella.htm
http://endocrine-disorders.health-cares.net/empty-sella-syndrome.php