The Empty Sella Is Not Empty

An empty sella is not really empty but filled with CSF. The term “intrasellar penetration of subarachnoid spaces” could be preferable. An empty sella is most of the time non symptomatic but a systematic hormonal checking could show a significant percentage of hypogonadism. A dehiscence of the sellar diaphragm is the main causal factor and an incomplete pneumatization of the sphenoid sinus could be an adjunctive factor in primary empty sella. The differential diagnosis is with intrasellar arachnoid cyst. A secondary empty sella occurs after pituitary surgery, radiotherapy or Sheehan syndrome or as a result of a cyst or tumor shrinkage. It is also frequently observed in multiparous women.