What does a partial empty sella (cystic change in the sella turcica) mean?

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From the Guidelines

A partial empty sella is a condition where the pituitary gland appears smaller than normal, with cerebrospinal fluid partially filling the sella turcica, and is often discovered incidentally during brain imaging studies like MRI or CT scans, with approximately 30% of patients demonstrating some hypopituitarism upon testing 1.

Definition and Diagnosis

A partial empty sella is characterized by the presence of cerebrospinal fluid in the sella turcica, which can compress the pituitary gland and potentially lead to hormonal imbalances. The condition can be diagnosed using MRI or CT scans, with MRI being the preferred diagnostic imaging modality for evaluation of the pituitary and sellar regions 1.

Clinical Significance

While many people with partial empty sella have normal pituitary function, some may experience hormonal imbalances that require evaluation by an endocrinologist. Symptoms, when present, can include headaches, vision changes, or hormonal issues like menstrual irregularities, fatigue, or decreased libido.

Key Points to Consider

  • Partial empty sella is more common in women, especially those who are overweight or have high blood pressure.
  • The condition occurs when there is a defect in the membrane separating the pituitary from the subarachnoid space, allowing cerebrospinal fluid to push into the sella and compress the pituitary gland.
  • MRI using high-resolution pituitary protocols is the preferred diagnostic imaging modality for evaluation of the pituitary and sellar regions 1.
  • Blood tests to check pituitary hormone levels may be recommended to determine if any hormone replacement therapy is needed 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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