Bjerre P
Department of Neurosurgery, Odense University Hospital.
Acta Neurol Scand Suppl. 1990;130:1-25.
The empty sella turcica is defined as a sella which, regardless of its size, is completely or partly filled with cerebrospinal fluid. An empty sella of normal size is a frequent and probably normal finding in unselected autopsy series. In clinical series an empty sella usually appears enlarged and is often associated with a variety of clinical disorders, constituting the so-called empty sella syndrome. Several causes of an enlarged empty sella have been suggested: a congenitally missing (deficient) sellar diaphragm with or without altered cerebrospinal fluid dynamics, previous pituitary gland hypertrophy or the outcome of a pituitary tumor necrosis. Increased intracranial pressure will induce a sellar enlargement in some patients and, consequently, also the emptiness. This pathogenesis is, however, applicable only in a minority of patients with an empty enlarged sella. Data from the literature and from own studies suggest that the enlarged empty sellae and the associated findings in the majority of cases are caused by spontaneous necrosis of a previous pituitary adenoma. This theory explains the frequent presence of pituitary insufficiency, pituitary hypersecretion, and visual field defects in patients with an empty sella. Furthermore, it offers an explanation of the finding of an empty enlarged sella in some patients with non-traumatic cerebrospinal fluid rhinorrhea and probably also benign intracranial hypertension. Thus, an empty enlarged sella is a stage in the spontaneous course of some pituitary adenomas and the associated findings constituting the empty sella syndrome are an occasional part of the clinical presentation of pituitary adenomas.
空蝶鞍被定义为蝶鞍，无论其大小如何，完全或部分充满脑脊液。在未选择的尸检系列中，正常大小的空蝶鞍是常见的，可能也是正常的发现。在临床系列中，空蝶鞍通常看起来增大，并且常与多种临床疾病相关，构成所谓的空蝶鞍综合征。已提出空蝶鞍增大的几种原因：先天性蝶鞍隔缺失（不足），伴或不伴有脑脊液动力学改变、既往垂体肥大或垂体肿瘤坏死的结果。颅内压升高在一些患者中会导致蝶鞍增大，进而也导致蝶鞍空虚。然而，这种发病机制仅适用于少数空蝶鞍增大的患者。来自文献和自身研究的数据表明，大多数情况下空蝶鞍增大及相关表现是由既往垂体腺瘤的自发性坏死引起的。该理论解释了空蝶鞍患者中垂体功能减退、垂体分泌过多和视野缺损的常见情况。此外，它还解释了一些非创伤性脑脊液鼻漏患者以及可能还有良性颅内高压患者中出现空蝶鞍增大的现象。因此，空蝶鞍增大是一些垂体腺瘤自然病程中的一个阶段，构成空蝶鞍综合征的相关表现是垂体腺瘤临床表现中偶尔出现的一部分。
