Incidentally-detected empty sellae

Abstract

Purpose: Empty sella syndrome (ESS) is being recognized increasingly because of the development of refined computed tomography (CT) techniques. ESS encompasses two distinct clinical entities. Primary benign and asymptomatic ESS occurs as an anatomic variation in the diaphragma sellae, a secondary syndrome occurs following surgery and/or irradiation or spontaneous regression of an intrasellar tumour and this may cause visual impairment post treatment. The aim of this study was to elucidate the possible association between age, ESS and any other pathological findings on brain CT studies, performed on 104 consecutive patients referred for various neurological and neurosurgical reasons. Methods: In this study, empty sellae were found frequently, seen in 54% of the patients who were referred for a CT study of the brain for different clinical complaints of various unrelated aetiologies. ESS was found in equal frequency in men and women. We divided the patients into six groups according to their CT findings in the brain, i.e. normal appearance, cerebral atrophy, infarction or haemorrhage, space occupying lesion and others. The degree of central and cortical atrophy, the existence of carotid artery calcification and the sella turcica size were also evaluated. Results: We found no correlation between the size of sellae or the presence of empty sellae and patients age or with age-related CT features. Conclusion: We suggest that an empty sella of normal size, with otherwise usual features, should be regarded as a normal anatomical variant.