The empty sella syndrome

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Abstract
Ten cases of the empty sella syndrome are presented. In four a pituitary adenoma had been treated by surgery with or without radiotherapy. In three women there was a close relation with pregnancy, and two boys had congenital malformations. Five cases presented with appearances of pseudotumour, and the remainder had cerebrospinal fluid (CSF) fistulas. Four fistulas were spontaneous, one was post-traumatic aggravated by the intrasellar implantation of YT-90. Two were occult CSF fistulas causing recurrent meningitis. Gamma cisternography and iodocisternography proved to be good diagnostic tests, both for the empty sella and for CSF fistulas. Nine cases were operated on. In four an intrasellar cyst was present. In the other five an empty sella with deficient or absent diaphragm was found. Treatment of most cases consisted of covering the floor of the sella with lyophilized dura, which was fixed in place with biological glue.