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Empty Sella and Headache
Authors:Teresa Catarci  Fabrizio Fiacco  Luigi Bozzao  Manuela Pati  Alice Valeria Magiar  Rosanna Cerbo
Institution:Department of Neuroscience (Vth Neurological Clinic, Prof. G.L. Lenzi), La Sapienza University, Rome, Italy; Department of Neuroscience (Neuroradiology Department), La Sapienza University, Rome, Italy; Vth Institute of Clinical Medicine, Chair of Andrology, Umberto I Hospital, Rome, Italy
Abstract:SYNOPSIS
Empty sella is an anatomical condition caused by herniation of the subarachnoid space into the pituitary fossa through an incompetent seller diaphragm. Headache seems to be one of the most frequently reported symptoms. We studied 13 headache patients (12 females, 1 male) presenting with primary empty sella (PES) on CT scan. The characteristics of the headache were analyzed and plasma levels of pituitary hormones or cortisol assessed. We confirmed the nonspecific nature of the headache in PES even though the majority of our patients complained of daily headache, mostly localized anteriorly. Hormone plasma levels were within normal range in all the patients assessed. However, four patients reported earlier endocrine disorders and more than half of the patients presented with obesity.
In our opinion, PES should be suspected in middle-aged overweight women with daily headache even in the absence of endocrine symptomatology.
Keywords:Empty sella  headache  pituitary  pathophysiology
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