Rizwan Ajmal.
Empty sella: it is worth mentioning in routine MR brain imaging: a review of 200 cases from a tertiary care hospital.
Pak J Radiol Jan ;29(2):83-9.

ABSTRACT BACKGROUND: Primary empty sella (PES) is regarded as an incidental finding but there are several studies documenting the association of PES with clinical, hormonal and imaging abnormalities. The primary empty sella (PES) or arachnoidocele is the herniation of subarachnoid space within the sella turcica in patients having no history of pituitary tumor, surgery, or radiotherapy. MATERIAL AND METHODS: This study is designed to retrospectively evaluate the selected variables including clinical features, biochemical endocrine functions and radiological imaging findings from the medical records of 200 patients with a diagnosis of PES on MR brain imaging. RESULTS: Out of 200 patients 41 (20.50%) were male and 159 (79.50%) were female. The mean age at the time of diagnosis was 56.87 years. In all the patients the diagnosis of PES was made by magnetic resonance imaging (MRI). In both the genders headache is the most prevalent symptom in our study seen in 67.5%. The second commonest association in male group is vertigo seen in 7.5% and obesity in female group seen in 28.5%. The third commonest association observed in male group found to be obesity in 6.5% and hypertension in female group seen in 26.5%. The least common association are ataxia and raised intracranial tension (ICT) seen only in 3% of cases. CONCLUSION: Primary empty sella is a condition ranging from asymptomatic population to patients with multiple clinical, neuroopthalmological and hormonal disorders. This wide range of variability reflect the diversity of its pathogenesis. Patients having severe intra-cranial tension (ICT), disabling headaches and severe visual disturbances should be evaluated for a potential neuro-surgical treatment. As our study is retrospective so no follow up data could be obtained. However due to risk of disease progression a regular radiological, endocrine and neuroopthalmological reassessment is recommended.

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