Thank you for posting your query at DoctorSpring.com
I have noted your symptoms, MRI brain findings, and your thinking about these. I appreciate your thoughts over the matter.
Regarding empty sella, it could be a normal finding in many.
In addition, empty sella can exist with idiopathic intracranial hypertension (increased pressure in the brain fluid). This can lead to headaches as well as decreased vision. Idiopathic intracranial hypertension can be excluded by doing a fundus examination (by an eye specialist). If the fundus shows evidence of high pressure (papillodema), then, a lumbar puncture may be needed.
Another possibility to be excluded with empty sella is hypopituitarism. For this, hormone tests for cortisol, thyroid and prolactin may be checked in the blood.
I hope it helps.
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist