Primary Empty Sella Syndrome (PESS) is a medical condition characterized by the presence of cerebrospinal fluid (CSF) in the sella turcica, a bony structure in the skull that houses the pituitary gland. In PESS, the sella turcica appears enlarged or flattened, with the pituitary gland appearing to be compressed or absent.
The term "primary" implies that PESS is not caused by any underlying disease or trauma, and is instead believed to be a congenital or developmental anomaly. It is commonly found incidentally during imaging studies conducted for unrelated reasons, as it is often asymptomatic.
The exact cause of PESS is not fully understood, but it is thought to be related to an abnormality or weakness in the diaphragma sellae, a structure which normally forms the roof of the sella turcica and helps maintain the shape of the pituitary gland. This weakness allows CSF to enter the sella turcica, leading to the characteristic empty appearance.
While PESS typically does not cause any symptoms or require treatment, in some cases it can be associated with hormonal imbalances or compression of the optic nerves, leading to symptoms such as headache, visual disturbances, or endocrine abnormalities. In such cases, treatment may involve hormone replacement therapy or surgical intervention to relieve pressure on the optic nerves.
In summary, Primary Empty Sella Syndrome is a medical condition characterized by the presence of CSF in the sella turcica. It is believed to be a congenital anomaly and is often asymptomatic, but in some cases may cause hormonal imbalances or compression of the optic nerves requiring treatment.
