| Male Infertility
| Sheehan's syndrome
| Acromegaly and Giantism
The pituitary shrinks or becomes flattened and the sella fills with CSF on imaging instead of the normal pituitary. The pituitary function is usually normal in 90% of cases
- Enlarged sella filled with CSF and so appears "empty"
- Most patients are female 80%, 70% are obese, 30% have hypertension
- Pituitary function is usually normal in 90% of cases
- The sella turcica is a saddle-shaped depression located in the bone
- Lies within the sphenoid bone at skull base
- Incomplete sellar diaphragm
- Primary: Defective enlarged diaphragma sella opening, Herniation of subarachnoid space to sella, raised ICP, developmental defect
- Secondary: Post infarction/haemorrhage /apoplexy, surgery, radiotherapy, postpartum pituitary necrosis (Sheehan's syndrome) , Idiopathic intracranial hypertension
- Primary disease is seen in Middle-aged women often asymptomatic and clinically not relevant.
- May be associated with chronic headaches
- Can cause secondary hyperprolactinaemia.
- Secondary disease: Hypopituitary due to cause
- Can cause Cerebral Diabetes Insipidus with polyuria and polydipsia
- FBC, U&E, LFT, CRP, Glucose
- Cortisol, TFT, PRL, oestrogen, testosterone and GH.
- Prolactin elevated due to stalk effect
- MRI pituitary or CT if MRI not possible
- Visual fields perimetry if there is concerned about visual defects
- Hormones replacement as needed if hypopituitary
- No treatment needed if otherwise well
- May need life time monitoring of pituitary function