Do you know the empty sella syndrome?

The brain still remains a mystery to human beings. For this reason, scientific research only progresses, day after day, in search of new findings that shed light on its functioning. The literature is increasingly extensive and The knowledge we have about the brain is broader and more precise. In this article we will cover empty sella syndrome.

But… What is the sella turcica? Many will nod their heads claiming to know what it is about. Others will be thinking: Do we have something called that in our heads? And others will think: sounds like something to me… This peculiar name comes from Latin, Turkish seal Apparently It is inspired by the shape of the structure of a saddle.

What is sella turcica and how does this syndrome occur?

Is about a brain structure occupied almost entirely by the pituitary gland. It is located just below the base of the brain. When the pituitary gland flattens or shrinks, the area appears empty. It is not seen on magnetic resonance imaging.

Although it is not really empty, but rather filled with cerebrospinal fluid. This fluid surrounds the spinal cord and brain. When the empty sella turcica syndrome (VTS)cerebrospinal fluid leaks into the sella and puts pressure on the pituitary gland, flattening or shrinking it.

Primary empty sella syndrome (PTPS)

Primary empty sella syndrome (OPTS) is still the subject of research. In this case, for now no previous pathological process has been found. Neither its pathogenesis nor its clinical-surgical impact are clear, so debates remain open. Even so, there is relevant data that, little by little, sheds more and more light.

Secondary empty sella syndrome (STVS)

Secondary empty sella syndrome (STVS) is caused by a pathological process. It may or may not be tumorous in nature. In most cases, it is usually an adenoma (benign epithelial tumor) that later regresses. This involution occurs spontaneously or with treatment. As a result of this, the arachnoid cistern at the base of the skull is introduced into the space that has been left empty inside the sella turcica.

Who does it affect and what symptoms does it present?

González-Tortosa (2009) highlights that they are usually patients between 40 and 50 years old. There is predominance in the female sex and with a high incidence of obesity. High blood pressure affects 23% of cases. 16.6% of these women are multiparous. Symptoms of headaches also occur. Another characteristic symptom of idiopathic intracranial hypertension is pulsatile ringing in the ears.

On the other hand, there can also be visual disturbances such as decreased visual acuity or blurred vision. The mental disorders Above all, symptoms of anxiety and behavioral alterations and dysthymia may also appear. In relation to the endrocrinological symptomsmenstrual alterations and sexual decline can be found in men.

Hypopituitarism

Hypopituitarism is a condition of the pituitary gland that causes abnormal secretion of some or all of its hormones. Among the different hormones we can find: prolactin, oxytocin, growth hormone, antidiuretic hormone, luteinizing hormone, etc.

The Necochea team (1998) points out that STV may be one of the causes of hypopituitarism. Another of the most common causes “are intrasellar or parasellar tumors, such as pituitary adenomas, craniopharyngiomas, meningiomas and lymphomas”. The authors also point to ischemic necrosis of the pituitary gland and pituitary ischemia due to vasculitis or diabetes myelitis as the cause.

On the other hand, It can also occur due to infection of the pituitary gland. These infections could be caused by tuberculosis, brucellosis, syphilis, mycosis. Or due to other diseases such as sarcoidosis, hemochromatosis and histiocytosis.

Empty sella syndrome in children

González-Fernández’s team (2009) found symptomatological differences between adults and children in the STV. One of these differences is that in children it is not seen in obese subjects. There is also no clear predominance of sexes and the sella turcica is not enlarged. This suggests that a different pathogenesis could occur in both.

As the authors point out, another of the different “is the hypothalamic-pituitary (HH) function.” Generally, HH hormonal function is not altered in adult patients, although it is not absolutely exempt from being found.. The authors place special emphasis on the study of the HH function, since it occurs more frequently in children than in adults.

You might be interested…