Empty sella: Meaning in a Radiology Report

Also written as: partially empty sella, empty sella turcica, primary empty sella

Empty sella means the bony pocket that holds the pituitary gland looks mostly filled with fluid, with the gland flattened against its floor.

What it means

The sella turcica is a small saddle-shaped hollow in the bone at the base of the skull, and it holds the pituitary gland. In an empty sella, brain fluid (CSF) pushes down into the hollow through a gap in the membrane above it. The gland is pressed flat against the floor, so the pocket looks empty on MRI. The gland is still there and usually works normally.

When it matters

A partially empty sella is a common chance finding, especially in adults, and often needs nothing further. Doctors look more closely if there are hormone symptoms. Headaches or vision changes can point to raised fluid pressure in the head (idiopathic intracranial hypertension). Then your doctor may suggest hormone blood tests or an eye examination. An empty sella can also follow pituitary surgery, radiation or illness.

Questions to ask your doctor

Is my pituitary gland working normally?
Should I have hormone blood tests or an eye examination?
Could this be linked to raised pressure in my head, or is it incidental?

General information, not medical advice. What a finding means for you depends on your symptoms, your history and the images themselves, so talk your results through with a doctor.