Empty sella turcica occurs as a result of intrasellar herniation of the suprasellar subarachnoid space with compression of the pituitary gland producing, in many cases, a remodeling of the sella; this results from a combination of an incomplete diaphragm sella and increased cerebrospinal fluid pressure. It is classified as primary or secondary.
Primary empty sella is more common in multiparous, hypertensive women who are obese. A common complaint is headaches; pituitary function is usually normal. Secondary empty sella is caused by pituitary disease, surgery, or irradiation. The predominant clinical finding in these patients is visual abnormality, resulting from arachnoidal adhesions and traction on the optic apparatus. Some patients can also have mild hyperprolactinemia caused by stretching of the pituitary stalk.