CT Scanning in Hypopituitarism (2) In the ‘empty sella’ syndrome, an enlarged pituitary sella is usually filled with CSF. This classically occurs in obese women who have headaches, but may also occur in symptom-free patients where the radiographic appearance is often found incidentally. The aetiology is unclear but it may result from herniation of arachnoid through the diaphragma sellae. Pituitary function is usually normal. In some patients, an enlarged empty sella may represent a partially or completely infarcted tumour, in which case the empty sella syndrome may be associated with hyperprolactinaemia, acromegaly, Cushing's disease, or a nonfunctioning tumour with or without hypopituitarism.