Empty sella syndrome - a collection of disorders of the nervous and endocrine systems and organs of vision, developing as a result of bulging membranes of the brain into the cavity sella with simultaneous compression and spreading it on the walls of one of the main endocrine glands - the pituitary gland.

Sella - this anatomical education, which is a portion of the sphenoid bone, participating in the formation of the skull base, and has a resemblance to the seats of Turkish riders, from which derives its name. The fovea is the pituitary sella - endocrine gland that produces hormones that are involved in the regulation of growth and development of the bodies of a number of metabolic processes of the body, as well as coordination of the functioning of organs and tissues. From the cranial cavity pituitary separate offshoot of the dura mater - the diaphragm sella.

The disease is more common in middle-aged (35-50 years), and women are diagnosed with it five times more often than men. According to statistics of the empty sella syndrome is more common among women who gave birth more than two times.

The disease is classified depending on the reason he was summoned into 2 types:

- Primary empty sella syndrome syndrome, which occurs without prior pituitary pathology, on the background of overall health;

- Syndrome secondary empty sella syndrome that develops as a result of the size reduction, either as a result of the destruction of the pituitary, increased by neoplastic processes after surgery or radiation exposure, hemorrhage into the tumor, etc. It always occurs on the background of failure sella diaphragm, which in turn may be congenital or may develop as a result of pituitary hyperplasia due to a number of diseases and physiological conditions (pregnancy, puberty, etc.).

Risk of expansion and weakening of the diaphragm rises and traumatic brain injuries, tumors and infections that affect the brain tissue and promote increased intracranial pressure.

Mechanism of empty sella syndrome is such that when the diaphragm failure meninges pressurized fluid circulating in them, are pressed into the cavity of the sella turcica, which leads to a thinning of the pituitary and the resulting disruption of its operation. Due to the transformation of the anatomical structures of the skull base disturbed pituitary control of the hypothalamus, resulting in the development of various endocrine disorders. Changing the location of the anatomical structures relative to the optic chiasm, and the lack of blood supply to the optic chiasma, develop disorders of the visual organs.

The symptoms of empty sella syndrome

The clinical picture of empty sella syndrome consists of spontaneously arising and disappearing symptoms of the nervous and endocrine systems and organs of vision. Very often, the primary form of empty sella syndrome occurs without any clinical symptoms, and can be detected incidentally during X-ray examination.

Neurological symptoms are almost always accompany this pathology, and tend to worsen during stressful situations. The most common symptom is a headache without a clear localization, at first light, recurring, and then turning into a constant. On the part of the autonomic nervous system has been a sharp increase in blood pressure, chills, pain in the heart, shortness of breath. Patients may complain of a lack of air, a sense of fear, pain in the abdomen and legs, as well as fever. In addition, the identified disorders of emotional and personal and volitional patient's psyche.

Disorders of the endocrine system due to lack or excess of pituitary hormones. Amid imbalance operation of the hypothalamic-pituitary system can develop diseases such as hyperprolactinemia, which leads to a decrease in sexual function, Cushing's disease, hypopituitarism, acromegaly, diabetes insipidus and other metabolic disorders.

Symptoms shown by the organs of vision in case of defeat chiasm optic nerve - the optic chiasm, and is characterized by pain in the periocular area. Patients complain of double vision, watery eyes, a feeling of "veil" in front of the eyes, deterioration of visual acuity. When ophthalmoscopy revealed swelling and redness of the optic disc and visual field change.

Several authors describe the combination of sella syndrome with small tumors of the adenohypophysis. Thus symptoms will depend on which part of the pituitary and struck respectively, synthesis and release of pituitary hormone violated.

Empty sella syndrome - treatment and prognosis

If you suspect an empty sella syndrome is carried out biochemical analysis of blood (in the presence of metabolic disturbances) and a blood test for levels of hormones, particularly prolactin and free T4 to identify endocrine disorders.

Possible to carry out X-ray examination of the skull with an eye in the sella. The most informative diagnostic methods are magnetic resonance imaging and computed tomography of the brain, which revealed signs of increased intracranial pressure, such as the expansion of the ventricles and the space occupied by the brain fluid. Thus pituitary vertical size does not exceed 3 mm and is shifted backwards or downwards.

Treatment of empty sella syndrome is aimed at addressing the symptoms of neuroendocrine, neurological and ophthalmic. Held drug therapy accompanying endocrine pathology, symptoms are eliminated by the autonomic nervous system. If there is pain recommended the appointment of painkillers. Despite the presence of the syndrome of the empty sella intracranial pressure, experts do not recommend to carry out its correction drugs.

Indications for surgical intervention may be seepage of cerebrospinal fluid through the bottom of the sella, which is to eliminate the bottom saddle tamponiruyut, as well as compression of the optic nerve resulting in sagging of the optic chiasm in the sella diaphragmatic opening.

Forecast syndrome empty sella heteroglossia, and often depends on the flow of related diseases of the brain and the pituitary gland.