Diagnosis and differential diagnosis of primary empty sella

: A report is given on 12 patients (6 men, 6 women) presenting primary Empty Sella who were admitted as inpatients with a provisional diagnosis of a hypophyseal tumour. The most frequent first symptom was uncharacteristic cephalgia. Visual disturbances and an impairment of potency/libido were only mentioned in the second place. 5 of the 12 patients were adipose and overweight, 2 of them additionally showed hypertensive blood pressure values. 2 female patients suffered from galactorrhoea. The typical "Empty Sella Patient" frequently described in the literature - the overweight medium-aged woman was an exception among our patients. Besides the ascertainment of the ophthalmological findings and the performance of a complete endocrinological function diagnosis the respective radiological diagnosis was established: native sellar picture, sella tomography, computer tomography, angiography and pneumocephalography. A high informative value in the differential-diagnostic demarkation from a hypophyseal tumour has until now been attributed to pneumoencephalography with an intracellar accumulation of air being considered to prove the presence of an empty sella. Under modern examination conditions, however, a computer-tomographic clearing will in most cases be possible.