Pediatric Empty Sella

  • Etiology: Herniation of arachnoid space into pituitary fossa through deficient diaphragma sellae
  • Imaging MRI:
    — Pituitary gland appears small or thin or invisible and cerebrospinal fluid fills the sella
    — Pituitary infundibulum can be seen to traverse the sella
  • DDX: Arachnoid cyst, Rathke cleft cyst, craniopharyngioma, cystic pituitary macroadenoma, epidermoid
  • Complications:
  • Treatment: None
  • Clinical:
    — Most commonly an incidental finding
    — Rarely can be due to idiopathic intracranial hypertension

Radiology Cases of Empty Sella

Radiology Cases of Empty Sella Due to Idiopathic Intracranial Hypertension

MRV of idiopathic intracranial hypertension
Sagittal T1 MRI without contrast of the brain (left) shows a nearly empty sella. 3D reconstruction of an MRV with contrast of the brain looking from the top down (right) shows stenosis of the lateral aspect of the transverse sinuses bilaterally.
MRI of empty sella in idiopathic intracranial hypertension
Sagittal T1 MRI with contrast of the brain shows the pituitary gland to be thinned and flattened in appearance. Most of the sella is filled with cerebrospinal fluid.