Pediatric empty sella syndrome

What is pediatric empty sella syndrome?

Your child’s pituitary gland is located in the center of their brain, behind their eyes and inside a bony structure called the sella turcica. The pituitary gland produces certain hormones and also controls the release of hormones from other glands.

When the pituitary gland appears to be shrunken or is not visible within the sella turcica, it is called empty sella syndrome. The empty space left is instead filled with cerebrospinal fluid - the fluid that surrounds the brain and spinal cord.

What are the different types of pediatric empty sella syndrome?

There are two types of empty sella syndrome:

• Primary empty sella syndrome happens when part of the brain pushes down into the sella turcica and flattens the pituitary gland. There is no known cause for why this happens in some children.
• Secondary empty sella syndrome happens when the pituitary gland is damaged.

What are the signs and symptoms of pediatric empty sella syndrome?

When symptoms do occur, they most commonly include:

• Early or delayed puberty 
• Erection problems (in boys)
• Fatigue (extreme tiredness)
• Headache 
• Irregular or absent menstruation (in girls of menstruation age)
• Leaking of cerebrospinal fluid from the nose
• Nipple discharge
• Slow growth
• Vision problems

Most of the time, there are no symptoms of empty sella syndrome.

How is pediatric empty sella syndrome diagnosed?

The only way to know if a child has empty sella syndrome is to examine the brain using imaging.

• Computerized Tomography (CT)
• Magnetic Resonance Imaging (MRI)

What are the causes of pediatric empty sella syndrome?

• Primary - There is no known cause for primary empty sella syndrome.
• Secondary
  • Injury
  • Radiation treatment for a pituitary tumor
  • Shrinking of the pituitary gland
  • Surgery to remove a pituitary tumor
  • Underdeveloped pituitary gland