Defects in the diaphragma sella may allow passage of cerebrospinal fluid (CSF) from the suprasellar cistern into the sella turcica, although it may also result from infarction or irradiation of a pituitary tumour. The condition is termed ΓÇÿempty sellaΓÇÖ and is usually an incidental finding. Differentiation from an intra- or suprasellar cyst is based on the normal location of the infundibulum, extending from the tuber cinereum to a small posteriorly displaced pituitary gland (Fig. 24.6). The clinical condition of ΓÇÿempty sella syndromeΓÇÖ has been applied to the combination of an ΓÇÿempty sellaΓÇÖ with the constellation of symptoms: headache, endocrine dysfunction, and visual disturbances.
Fig. 24.6 Empty sella. Sagittal T1-weighted post-contrast MR image (a) showing a large ΓÇÿempty sellaΓÇÖ, with an elongated infundibulum inserting into a thin enhancing pituitary gland. Coronal CT (b) in a different patient showing insertion of the infundibulum into a thin pituitary.
