[Primary empty sella turcica. Analysis of 14 cases and review of the literature].

14 patients (13 women, 1 man) presenting with primary empty sella had endocrinologic and radiological investigations. 8 women are obese, 5 multiparous. Initially, headaches have needed a radiological study of sella turcica in 8 cases (57%). Pneumoencephalography and/or CT scan have led to diagnosis; but in 3 cases, a suspected associated pituitary adenoma justified a surgical exploration. In one case, a GH-secreting microadenoma was found, in both other cases histologic studies revealed fibrous or normal pituitary. Endocrine findings were normal, regarding to gonadotrophs, corticotrophs and thyreotrophs. GH was blunted in four cases, below 5 ng/ml during insulin tolerance test. In 9 cases, GH rose to 19,51 +/- 10,03 ng/ml (mean +/- S.D.). In 13 patients, serum prolactin was normal: 7,1 +/- 3,9 ng/ml (normal values 2 -20 ng/ml), elevated in the last case: 112,5 ng/ml. One year later, two patients did not show any modification on clinical, radiological or endocrine data. Physiopathology of intrasellar arachnoidocele is discussed: intrasellar extension of subarachnoid space may be due to diaphragm insufficiency and disturbances of dynamics of cerebrospinal fluid, flattening the otherwise normal pituitary gland.