Search

To assess the sonographic visualization of the fetal optic chiasm (OC) and optic tracts (OTs), establish mid-trimester reference values, and assess the relationship between OC and OT dimensions and cavum septum pellucidum (CSP) measurements.This prospective cross-sectional study included 154 morphologically normal fetuses between 19 and 23 weeks of gestation. The diameters of the fetal OC and OTs were measured using two-dimensional transabdominal ultrasound in a transventricular axial section angled approximately 20–40° caudally. CSP length as well as anterior, middle, and posterior widths were measured by placing the cursor on the inner surfaces in the transventricular section. The average CSP width was included in the analysis.The OC and OTs were successfully visualized in 109 fetuses and included in the analysis. Visualization success in transabdominal axial sections at 19–23 weeks was 70.8 %, with high intraobserver and interobserver reproducibility. Additionally, visualization rates were higher in advanced gestational weeks and in fetuses with breech presentation (p=0.007 and p=0.017, respectively). OC and OT dimensions were positively correlated with CSP length and width, biparietal diameter (BPD), head circumference (HC), and gestational age (p<0.05, for all).The OC and OTs were successfully visualized transabdominally in axial sections with high intraobserver and interobserver reproducibility. Additionally, OC and OT dimensions were positively correlated with gestational age, as well as with BPD, HC, and CSP measurements. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of the present study is to compare the cavum septum pellucidi (CSP) z-score in euploid and aneuploid fetuses and to investigate the performance of the CSP width/length and CSP width/biparietal diameter (BPD) ratios as a diagnostic marker in aneuploidy. Methods A total of 54 patients, 20 aneuploid and 35 euploid fetuses, between 18 and 37 weeks of gestation, were included in this retrospective study. The CSP width z-score was compared between the two groups. Receiver operating characteristic (ROC) curves were calculated for the CSP width/length and CSP width/BPD ratios to predict aneuploidy. Results The median CSP width was 4.8 mm (range, 1.8 to 8.5 mm) in the euploid group, and 5.4 mm (range 3.1 to 8.4 mm) in the aneuploid group. Cavum septum pellucidi width z-score, CSP width/length ratio, and CSP width/BPD ratio were significantly higher in fetuses with aneuploidy than in fetuses with normal karyotype (p= 0.001; p= 0.013; p= 0.028). In the ROC analysis, the CSP width/length ratio had the optimal cutoff value of 0.59, with 72.0% sensitivity and 58.0% specificity, and for the CSP width/BPD ratio, the cutoff value was 0.081 with 83.0% sensitivity and 61.0% specificity for detection of aneuploidy. Conclusion CSP width z-score was found to be increased in aneuploid fetuses. The CSP width /BPD ratio can be used as a new marker for predicting aneuploidy.

Spontaneous regression of cysts of the cavum septi pellucidi (CSP) and cavum vergae (CV) is rare and little discussed. The authors present their case report of this phenomenon following a severe headache in a 23-year-old woman, in whom magnetic resonance imaging (MRI) had previously confirmed significant thinning of the left lateral cyst wall. We consider this finding to be a possible predisposing factor to rupture and the spontaneous regression of such cysts. In addition to the mechanism of cyst regression, the interrelated causes of their expansion and formation will be discussed. [ABSTRACT FROM AUTHOR]

Cavum septum pellucidum (CSP) is a normal anatomical variant that is largely asymptomatic, though in rare cases can cause headache, developmental delay, and even acute hydrocephalus. There exist many surgical treatments in these symptomatic cases, though no one treatment has been deemed superior. In this report, we describe bilateral fenestration of the septum pellucidum with flexible endoscopy via a right frontal approach in a patient with exercise-induced headaches.The patient is a 17-year-old male who experienced headaches for six years that were progressively worsening with exercise and bearing down with associated emesis. Imaging evaluation demonstrated a CSP cyst. The decision was made to treat via bilateral septostomy with flexible endoscopy. He progressed appropriately and his headaches have now resolved.There is debate regarding if unilateral vs bilateral septostomy, placement of CSF diversion device, or performing endoscopic third ventriculostomy is superior. In this report, we present a case where bilateral septostomy in a patient with episodic headache yields complete resolution of symptoms.

Introduction: We aimed to investigate the relationship between cavum septum pellucidum (>6 mm) and cavum septum pellucidum et vergae with psychopathology and neuropsychological functions in individuals with these conditions by comparing them with normal cranial imaging. Methods: Thirty subjects with cavum septum pellucidum and cavum septum pellucidum et vergae on cranial magnetic resonance imaging and 30 controls without pathology on cranial magnetic resonance imaging were included in our study. A sociodemographic data form, Beck Anxiety Inventory, Beck Depression Inventory, and Barratt Impulsivity Scale-11 were applied to the participants. When it comes to neuropsychological functions, digit span test, Boston Naming Test, Verbal Memory Processes Test, Benton Face Recognition Test, Stroop Test, Verbal Fluency Test, and Wisconsin Card Sorting Test were applied to the patients. Results: In the anomaly group, 26 had cavum septum pellucidum et vergae, while 4 had enlarged cavum septum pellucidum, presenting no statistically significant difference in the rates of psychiatric disease between the anomaly and the control group. The group with enlarged cavum septum pellucidum and cavum septum pellucidum et vergae had lower performances in working memory, naming, attention, and executive functions than the controls. Conclusions: Abnormal developmental processes related to the formation and maturation of the septum pellucidum may be responsible for widespread cognitive impairments where these anomalies may act as an indicator for these conditions. In order to better understand the relationship of these anomalies with neuropsychological functions and psychiatric disorders, further studies with larger samples are needed. [ABSTRACT FROM AUTHOR]

In our case report, a 29-year-old male patient with a known history of schizophrenia presented with altered mental status and catatonia and was found to have an enlarged (21mm) cavum septum pellucidum (CSP) on magnetic resonance imaging (MRI). He was subsequently treated with escitalopram, olanzapine, methylphenidate, lorazepam, and eight electroconvulsive therapy (ECT) treatments during his hospital course, after which his catatonia improved. We compared this to other cases in which a large CSP was identified and discussed the possibility of increased susceptibility to psychosis, specifically catatonia, which might be associated with this developmental anomaly. [ABSTRACT FROM AUTHOR]

Christy L Pylypjuk,1 Shiza F Memon,2 Bernard N Chodirker3 1Department of Obstetrics, Gynecology and Reproductive Sciences (Section of Maternal-Fetal Medicine), Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; 2Department of Obstetrics, Gynecology & Reproductive Sciences, University of Manitoba, Winnipeg, MB, Canada; 3Departments of Pediatrics and Child Health (Section of Genetics and Metabolism) & Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB, CanadaCorrespondence: Christy L Pylypjuk, WN5002, HSC Women’s Hospital, 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada, Tel +1 204 787-4821, Fax +1 204 787-2920, Email cpylypjuk@hsc.mb.caObjective: To evaluate the utility of measuring fetal cavum septum pellucidum (CSP) width during routine, mid-pregnancy ultrasound for improving diagnosis of 22q11.2 deletion syndrome amongst fetuses with and without conotruncal anomalies.Patients and Methods: This was a retrospective case-control study (2005– 2016). Fetuses and newborns with 22q11.2 deletion and/or conotruncal cardiac anomalies were identified using a regional, clinical database. A control group was assembled in a 2:1 ratio to create three groups for comparison: i) 22q11.2 deletion syndrome; ii) isolated conotruncal anomalies; and iii) controls. Eligibility was restricted to those with stored ultrasound images between 18– 22 weeks’ gestation and a minimum biparietal diameter of 40 mm. Post-processing measurement of CSP width was performed in a standardized fashion by two blinded and independent study personnel. Descriptive and inferential statistics, regression modeling, and receiver operator curves (ROC) were used to compare outcomes between groups and evaluate sensitivity/specificity of CSP width as a marker of 22q11.2 deletion syndrome.Results: Twenty-nine cases of 22q11.2 deletion and 64 cases of isolated conotruncal anomalies were matched to 186 healthy controls. Cases with 22q11.2 deletion syndrome had significantly larger CSP widths (5.36 mm; SD=1.2) compared to those with isolated conotruncal anomalies (3.75 mm; SD=1.11) and healthy controls (2.93 mm; SD=0.57; p< 0.0001). There was no difference in CSP width amongst those with 22q11.2 deletion irrespective of the presence/absence of a conotruncal anomaly (p=0.362), or by type of conotruncal anomaly (p=0.211). Using a CSP width cutoff > 4.3 mm, fetuses with 22q11.2 deletion can be accurately identified with good sensitivity (89.7%) and specificity (84%).Conclusion: Fetuses with 22q11.2 deletion syndrome have dilated CSPs when compared to those with isolated conotruncal anomalies or controls. Because CSP dilation can be evaluated during routine mid-pregnancy ultrasound using standard images of the fetal head, measurement could easily be incorporated to enhance prenatal diagnosis of this phenotypically diverse condition.Keywords: DiGeorge syndrome, 22q11 microdeletion, cavum septum pellucidum, prenatal diagnosis, fetal ultrasound, neurosonography

Background: The cavumseptum pellucidum is an important marker for identifying and evaluating the fetal neural axis. Evaluation of the characteristics of the Cavumseptum pellucidum is recognized as an important (fetal) factor for fetal ultrasound in the second and third trimesters of pregnancy. Objectives: This study aimed to evaluate the size range of cavum septum pellucidum in the second and third trimesters of pregnancy in women referred to Ali Ibn-e Abitaleb Hospital Clinic of Zahedan. Methods: This was a descriptive-analytical study performed at Ali Ebne Abitaleb Hospital of Zahedan in 2018. Ultrasound examinations were performed on all pregnant women in the second trimester (18 to 20 weeks) and third (36 to 38 weeks). Information such as maternal age, size of septum pellucidum, and gestational age were included in the checklist. Ultimately, the data were entered into SPSS software for statistical analysis. Results: In this study, a total of 500 fetuses were evaluated. The mean age of the mothers under study was 26.36 years old. The mean cavum septum pellucidum size in the second trimester was 3.71 ± 0.81 and 6.11 ± 1.09 mm in the third trimester. The mean size of cavum septum pellucidum in the second trimester of pregnancy was significantly lower than in the third trimester (P < 0.001). Conclusions: The mean size of cavum septum pellucidum in the present study was 4.91 mm, similar to the size of other studies. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between cavum septum pellucidum (CSP) and corpus callosum (CC) length and width measurements in mid-trimester sonographic screening in normal fetuses., Methods: This prospective cohort study examined 152 pregnant women who underwent mid-trimester sonographic fetal anomaly screening. CSP and CC lengths and their anterior, middle, and posterior width measurements were examined sonographically. The association between length and width measurements of both structures, gestational week and CSP ratio (length/width) were evaluated., Results: The mean CSP length was 7.96 ± 1.09 mm, and the mean middle width was 3.43 ± 0.82 mm. The mean CC length was 20 ± 3.76 mm, and the mean middle width was 3.43 ± 0.82 mm. There was a positive correlation between CSP and CC lengths (r = 0.691, p < 0.001). There was also a significant correlation between CSP and CC anterior, middle and posterior widths (anterior (r = 0.366, p < 0.001), middle (r = 0.305, p < 0.001), and posterior (r = 0.233, p = 0.004)). All CSP and CC measurements were correlated with gestational age, biparietal diameter (BPD), and head circumference (HC) (p < 0.001, for all). The CSP ratio was not related to CC dimensions (p > 0.05, for all) and also decreased with the increase in BPD and HC dimensions (r = -0.186, p = 0.022, and r = -0.174, p = 0.032; respectively)., Conclusion: In normal fetuses, the length and width of the CC and CSP structures developed in relation to each other, as well as to the gestational week, BPD, and HC dimensions. In addition, while the CSP ratio was not found to be associated with CC dimensions, it decreased due to the increase in BPD and HC sizes., (© 2024 Wiley Periodicals LLC.)

This study aimed to determine cavum septum pellucidum (CSP) nomogram values between 15–28 weeks of gestation. Routine biometric measurements and CSP width were measured by transabdominal ultrasonography in 6042 structurally normal foetuses between 15–28 weeks of gestation. Distribution of CSP width by the week of pregnancy and percentile values were calculated. The mean week of gestation (GW) was 21 ± 1.7, and the mean biparietal diameter (BPD) was 50.2 ± 5.8 mm. The CSP width range was 1.6–7.7 mm at 15–28 weeks, and the mean CSP width was 4.1 ± 0.8 mm. CSP width was found to have a significant correlation between a gestational week (CSP = GW X 0.2705–1.6121; R = 0.62; p <.01) and BPD (CSP = BPD X 0.0859–0.273; R = 0.651; p 0.01). CSP width was found to differ significantly according to gestational weeks, and percentile distributions were calculated. Between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7–7 mm. Our study was determined that CSP width increased linearly between 15–28 weeks of gestation. For this reason, we think that it would be more appropriate to use CSP width percentile values in the examination of the foetus. What is already known on this subject? The cavum septum pellucidum can be easily identified and evaluated by ultrasonography after 18 weeks of pregnancy. CSP can be associated with severe brain anomalies if it is not visualised or deformed. Moreover; large CSP may be associated with chromosomal abnormalities. What do the results of this study add? Our study showed that CSP width increased linearly between 15–28 weeks of gestation. CSP width was found to differ significantly according to gestational weeks, and between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7–7 mm. What are the implications of these findings for clinical practice and/or further research? We reported that it would be more appropriate to use CSP percentile values according to the gestational week in the definition of abnormal CSP. [ABSTRACT FROM AUTHOR]

Objective: A cavum septum pellucidum (CSP) has been reported as a visible brain anomaly in normal individuals as well in some former combat and collision sport athletes. The appearance of CSP with fenestrations and ventricular enlargement are considered associated features of the neuropathological diagnosis of chronic traumatic encephalopathy. The current study examined CSP anatomic features and lateral ventricle size in retired elite rugby league players and controls. Methods: Forty-one retired rugby league players and 41 healthy community controls, similar in age and education, underwent structural MRI scans. CSP grade, CSP length, corpus callosum septal length, and Evans' ratio (for lateral ventricle size) were rated by two of the current study authors. All participants also self-reported concussion exposure histories, depressive symptoms, daytime sleepiness, and impulsivity. They completed a neuropsychological test battery assessing premorbid intellectual functioning, attention, processing speed, language, visuospatial skills, memory, and aspects of executive functioning. Results: The two raters had high agreement for CSP grade (Cohen's κ = 0.80), CSP length [intraclass correlation (ICC) = 0.99], corpus callosum septal length (ICC = 0.73), the CSP/septal ratio (ICC = 0.99), and the Evans' ratio (ICC = 0.75). Twenty-five retired players (61.0%) had an abnormal CSP compared to 17 controls [41.5%; χ (1 , 82) 2 = 3.12, p = 0.08, odds ratio = 2.21]. The CSP/septal ratio was larger for retired players than for the controls. The Evans' ratio did not differ between the two groups. In the retired rugby league players (n = 41), those with normal (n = 16) and abnormal (n = 25) CSP grades did not differ across age, age of first exposure to collision sport, years of sport exposure, concussion history, or 23 clinical and cognitive variables. Conclusion: This study revealed a difference in the size of the CSP between retired professional rugby league players and controls. There was no significant difference in the size of the ventricles between the two groups. There were no significant differences between those with vs. without an abnormal CSP on age of first exposure to rugby league, years of exposure to repetitive neurotrauma, number of lifetime concussions, depression, impulsivity, perceived cognitive decline, or on any neuropsychological test. [ABSTRACT FROM AUTHOR]

ObjectiveA cavum septum pellucidum (CSP) has been reported as a visible brain anomaly in normal individuals as well in some former combat and collision sport athletes. The appearance of CSP with fenestrations and ventricular enlargement are considered associated features of the neuropathological diagnosis of chronic traumatic encephalopathy. The current study examined CSP anatomic features and lateral ventricle size in retired elite rugby league players and controls.MethodsForty-one retired rugby league players and 41 healthy community controls, similar in age and education, underwent structural MRI scans. CSP grade, CSP length, corpus callosum septal length, and Evans' ratio (for lateral ventricle size) were rated by two of the current study authors. All participants also self-reported concussion exposure histories, depressive symptoms, daytime sleepiness, and impulsivity. They completed a neuropsychological test battery assessing premorbid intellectual functioning, attention, processing speed, language, visuospatial skills, memory, and aspects of executive functioning.ResultsThe two raters had high agreement for CSP grade (Cohen's κ = 0.80), CSP length [intraclass correlation (ICC) = 0.99], corpus callosum septal length (ICC = 0.73), the CSP/septal ratio (ICC = 0.99), and the Evans' ratio (ICC = 0.75). Twenty-five retired players (61.0%) had an abnormal CSP compared to 17 controls [41.5%; χ(1, 82)2 = 3.12, p = 0.08, odds ratio = 2.21]. The CSP/septal ratio was larger for retired players than for the controls. The Evans' ratio did not differ between the two groups. In the retired rugby league players (n = 41), those with normal (n = 16) and abnormal (n = 25) CSP grades did not differ across age, age of first exposure to collision sport, years of sport exposure, concussion history, or 23 clinical and cognitive variables.ConclusionThis study revealed a difference in the size of the CSP between retired professional rugby league players and controls. There was no significant difference in the size of the ventricles between the two groups. There were no significant differences between those with vs. without an abnormal CSP on age of first exposure to rugby league, years of exposure to repetitive neurotrauma, number of lifetime concussions, depression, impulsivity, perceived cognitive decline, or on any neuropsychological test.

Background: Abscesses of the cavum septi pellucidi (CSP) or cavum septi pellucidi et vergae (CSPV) are exceedingly rare with only ten cases previously reported. As so few cases have been published, there is no consensus on optimal management strategies with some recommending operative drainage and some suggesting more conservative approaches. Case description: In this study we present the first reported case of a 51-year-old male presenting with syndrome of inappropriate antidiuretic hormone secretion and abscess of the CSPV secondary to otomastoiditis, treated successfully with intravenous antibiotics. A comprehensive review of the literature on CSP and CSPV abscesses was conducted with a focus on management strategies. Conclusions: We conclude, clinical condition permitting, that medical treatment should be the initial strategy selected for the management of CSP and CSPV abscesses.

Introduction: The third ventricular tumor is one of the most difficult lesions to approach. However, if a cavum septum pellucidum (CSP) and cavum vergae (CV) are present, approaching the tumor might be easier by exploiting them. Here, we describe the achievement of a favorable outcome in treating a patient with third ventricular tumor with CSP and CV using an anterior transcallosal interforniceal approach for tumor removal. Case description: A 52-year-old woman presented with acute hydrocephalus symptoms. Head imaging revealed a tumor filling the third ventricle and protruding into the right lateral ventricle through the right foramen of Monro. We also confirmed the presence of CSP and CV. After ventricular drainage, we performed a craniotomy to remove the tumor via an anterior transcallosal interforniceal approach. Almost all of the intraventricular tumor was removed easily without any complications, such as memory impairment. Conclusion: If CSP and CV are present, an anterior transcallosal interforniceal approach can be safely and effectively used to remove a third ventricular tumor.

Background: Cavum septum pellucidum (CSP) and cavum vergae (CV) are normal anatomical variations present in some children, adolescents, and adults. When the cavity is larger than normal, it is called a cyst. Symptomatic cases of CSP and CV cyst are rare, and the clinical presentation is varied. A case with multiple nerve involvement is described. Case Description: A healthy 17-year-old female presented a sudden headache, right cervicobrachialgia, right ptosis, visual changes, and left facial paralysis over 10 days. Head magnetic resonance imaging revealed CSP and CV cyst. Inflammation, infection, and vascular disorders were ruled out. We decided to perform a right transfrontal endoscopic intraventricular septostomy and a right Monro foraminoplasty, which were successful. One month after surgery, the patient had no more signs or symptoms. She has remained asymptomatic for the past year. Conclusion: Multiple nerve involvement was directly related to CSP and CV cyst. The cyst bilaterally occluded the foramen of Monro causing intracranial hypertension. It was possible to obtain complete resolution of the clinical features through neuroendoscopic fenestration and foraminoplasty. [ABSTRACT FROM AUTHOR]

Background: Hemorrhagic lesions of the septum pellucidum are rare and usually occur in neonates. They can be due to a number of etiologies. Here, we report a rare case of adolescent nontraumatic septum pellucidum hemorrhage with a review of literature. Case Description: A 16-year-old girl presented with a 1-month history of gradual visual deterioration in the left eye, intermittent headache, and vomiting. Brain imaging showed hematoma located between the leaflets of the septum pellucidum with obstructive hydrocephalus. Transcallosal resection of interventricular mass was done. The patient was discharged with improved neurological symptoms; however, the left eye vision did not recover. Imaging demonstrated a unique anatomical variant in deep vascular structures. Conclusion: Cavum septum pellucidum hemorrhage is rare in adults. Many theories were constructed to explain its etiology. Bleeding due a vascular anatomical variant was not previously encountered. Understanding the embryological origin and anatomical details are important for proper clinical assessment and management of these patients. [ABSTRACT FROM AUTHOR]

Cavum septum pellucidum (CSP) and cavum vergae (CV) cysts are commonly found incidentally. They are usually asymptomatic but may present with symptoms related to obstructive hydrocephalus. There is no consensus about the management of symptomatic CSP and CV cysts. We present, to the best of our knowledge, the first systematic review of the different treatment options for symptomatic CSP and CV cysts. We conducted a literature review using PubMed database, searching for cases of symptomatic CSP and CV cysts managed surgically, and published until April 2019. Preoperative characteristics, surgical procedure, and postoperative outcome were analyzed using SPSS® software (Statistical Package for Social Sciences, IBM®). We found 54 cases of symptomatic CSP and CV cysts managed surgically (34 males, 20 females, 1.7/1 male to female ratio). Mean age was 24.3 ± 20.1 years. The most common presentation was headaches (34 patients, 62%), followed by psychiatric symptoms (27 patients, 49.1%). Preoperative radiological hydrocephalus was present in 30 patients (54.5%). The most common surgical procedure was endoscopic fenestration (39 patients, 70.9%), followed by shunting (10 patients, 18.2%), open surgery (3 patients, 5.5%), and stereotactic fenestration (1 patient, 1.8%). Complete resolution of symptoms was achieved in 36 patients (65.5%) and partial resolution in 7 patients (12.7%), and symptoms were unchanged in 2 patients. The present review suggests that surgical treatment could provide resolution of the symptoms in most of the cases, regardless of the procedure performed. Although mean follow-up was short among the studies, recurrence rate was low. [ABSTRACT FROM AUTHOR]

Background/Aim: The septum pellucidum (SP) is the thin layer formed by the two laminas that form the medial wall of the lateral ventricle. When the laminas do not fuse, a cavity called cavum septum pellucidum (CSP) or Cavum Vergae (CV) forms. CSP is a developmental anomaly with unclear pathological significance and is common in people with neuropsychiatric diseases, especially schizophrenia, as well as post-traumatic stress disorder, Tourette's disease, and patients who suffer from recurrent and severe head trauma. However, few studies in the literature examine the CSP morphology among healthy individuals. Therefore, we aimed to evaluate the morphology and variations of septum pellucidum in healthy individuals. Methods: In this retrospective cohort study, the septum pellucidum was morphologically evaluated in 509 patients who underwent brain Magnetic Resonance Imaging (MRI) at Sakarya University Faculty of Medicine, Sakarya Training and Research Hospital. We classified the anatomical variations of the septum pellucidum as CSP, CV, CVI and evaluated their dimensions. Results: CSP was detected in 11.98% of the cases, and CV, in 1.38%. While 55.74% of individuals with CSP were male, 44.26 % were female. The mean CSP length and height were 7.71 (2.95) mm (P=0.103), and 2.80 (1.12) mm (P=0.649), respectively, and the mean length and height of the SP were 30.98 (7.36) mm (P=0.001), and 11.89 (3.32) mm (P=0.042), respectively. Conclusion: Knowledge of CSP, one of the septum pellucidum variations, is of great importance in the differential diagnosis of midline cystic mass lesions. Its volumetric changes may be related to the development of psychiatric disorders in childhood and adulthood. [ABSTRACT FROM AUTHOR]

Colloid cysts (CC) occur predominantly in the midline with majority involving roof of the third ventricle. In cases of cavum septum pellucidum (CSP), the surgeon can lose orientation when normal intraventricular structures are not encountered during surgery. We report a patient with CSP, who underwent right frontal parasagittal craniotomy, interhemispheric, transcallosal approach to reach the lesion. Lesion may not be seen in its usual location of foramen of Monroe, and entering the cavum may be confusing because no intraventricular landmarks will be seen. Excision of the cyst through the cavum usually requires interfornicial approach, and this structure must be separated gently to avoid injury.

Colloid cyst is a rare benign intracranial lesion. Due to its embryologic origin and development, it is commonly located within the third ventricle, though it also presents at various locations. Its location within cavum septum pellucidum is rarely reported. Operative approaches to such lesion can be challenging and misleading due to intraoperative variations. However, surgical resection in such locations are simplified and perfected with stereotactic guidance. A case of colloid cyst within the cavum septum pellucidum and the importance of stereotactic guidance in precisely reaching the lesion, thus minimizing the dissection of corpus callosum, are discussed.

Objective: To describe the cavum septum pellucidum (CSP) and cavum vergae (CV) findings. Methods: Thirteen samples were recruited in the study. The study was conducted at the Department of Neurosurgery, Dr. Hasan Sadikin Hospital, Bandung, Indonesia in the period of 2015–2016. Thirteen samples were recruited for the study. Cavum septum pellucidum and CV spaces are relatively rare. During neurology and neurosurgery examination of patients with head computed tomography (CT) scan and magnetic resonance imaging (MRI), CSP and CV were discovered accidentally. The incidence of these unique spaces reported from many countries, but have never been reported from Indonesia. Results: This is the first-time reported incidental finding of CSP and CV from Indonesia, 13 cases in one-year period. Since the presence of CSP and CV is usually asymptomatic, clinician seem don’t really care to put it in their report. Conclusions: The presence of CSP and CV as a common incidental finding can be more revealed in our country in years to come and hopefully can be more studied in term of anatomical landmark on neurosurgical field.

Supratentorialintraventricularepidermoids are very rare and midline septal pellucidal epidermoids are even more uncommon with only one case being reported in available literature. A 42-year-old lady with no previous complaints was admitted to the emergency services with history of intermittent headache, vomiting and giddiness of 3 months duration. A cranial computed tomography (CT) revealed a hypodense, non-enhancing intraventricular mass lesion and cranial magnetic resonance imaging (MRI) demonstrated a non-enhancing mass lesion in the septum pellucidum suggestive of an epidermoid. She underwent endoscopic-assisted surgery via an interhemispheric transcallosal approach. Intra-operatively, the lesion was located in the enlarged cavum septum pellucidum and was removed totally. An extensive literature review unearthed only 10 cases of intraventricular epidermoids and one in the septum pellucidum. We present only the second case of a midline septum pellucidum epidermoid and reflect on the paucity of supratentorial intraventricular midline epidermoids.

Purpose: This study was undertaken to evaluate the performance of indirect sonographic signs in detecting partial agenesis of the corpus callosum (pACC) at midgestation, focusing on the cavum septum pellucidum (CSP) ratio.Methods: A retrospective case-controlled study of singleton pregnancies was conducted, examining fetuses diagnosed with isolated pACC and normal controls. At midgestational age, fetal head volumes were imaged with 3D US and stored for the evaluation of indirect sonographic findings in axial planes.Results: Fifteen normal and 15 abnormal fetuses (with pACC) were analyzed. Based on a CSP ratio < 1.5, detection of pACC increased from 66.7% (10/15) to 80% (12/15). All indirect signs proved highly suspicious for pACC (risk ratios > 1).Conclusion: Use of indirect sonographic signs to screen for pACC at midgestation is challenging. However, a low CSP ratio may improve the detection rate, serving as a new indirect sign. [ABSTRACT FROM AUTHOR]

Aim: Holoprosencephaly (HPE) is the most common brain malformation. A wide spectrum of anatomical variants are characterized by a lack of midline separation of the cerebral hemispheres. The aim of this study was to assess the ultrasound diagnostic criteria for HPE.Material and Method: A database of 175 fetuses with central nervous system anomalies identified by ultrasound was collected retrospectively from 2006 to 2016 in this multicenter, retrospective, observational study. Among them 18 cases (10.2%) with HPE were identified.Results: The prevalence of HPE was 2.5:10.000 with the sex distributionmale:female of 1:1.6. Six cases were alobar subtype, 3 were semilobar, 7 were lobar and 2 were middle interhemispheric variant. In the second trimester, we consider that the abnormal fusion of the lateral ventricles and the absence of the cavum septum pellucidum are the most important landmarks for HPE. Facial abnormalities varied considerably.Conclusion: This study illustrates the heterogeneity of HPE with different cerebral and facial appearances. [ABSTRACT FROM AUTHOR]

Highlights • Small CSP is common in both incarcerated and non-incarcerated women. • CSP size is positively related to interpersonal traits of psychopathy in women. • CSP size is positively related to antisocial traits of psychopathy in women. • These effects are stable across gender for interpersonal elements. • Effects of antisocial elements are unique to females and may be dependent on gender. Abstract Cavum Septum Pellucidum (CSP) is a common anatomical variant of the septum pellucidum. CSP is considered a marker for abnormal limbic brain development, but its functional consequences are non-specific. In a recent report (Crooks et al., 2018), CSP size was significantly positively correlated with the affective/interpersonal traits of psychopathy in male offenders (N = 1742). Here we test the hypothesis that CSP is related to psychopathic traits in incarcerated females (N = 355). We examine continuous relationships as well as categorical assignments for CSP size corresponding to a number of prior reports. We also compare female offenders to healthy female controls (N = 385). Consistent with our reported findings in males, a positive association was observed between the interpersonal psychopathic traits and CSP size. In contrast to findings among males, an association between CSP and antisocial psychopathic traits was apparent in females. There was no significant difference in CSP size (in mm) or CSP presence/absence between incarcerated and non-incarcarated groups. However, categorical rates of medium and large CSP were more common in female inmates than in controls. This is the first systematic investigation of these variables in a female inmate sample. In combination with our prior study, these findings demonstrate that limbic abnormalities, as indexed by CSP, are related to psychopathic traits in both female and male inmates. [ABSTRACT FROM AUTHOR]

Mutations in Fibroblast Growth Factor Receptor II (FGFR2) have been identified in patients with Crouzon and Pfeiffer syndrome, among which rare mutations of the intracellular tyrosine kinase domain. Correlating subtle phenotypes with each rare mutation is still in progress. In Necker-Enfants Malades Hospital, we identified three patients harboring three different pathogenic variants of the same amino acid residue Asn-549 located in this domain: in addition to a very typical crouzonoid appearance, they all developed clinically relevant hydrocephalus, which is an inconstant feature of Crouzon and Pfeiffer syndrome. Overall, FGFR2 tyrosine kinase domain mutations account for 5/67 (7.4%) cases in our hospital. We describe a novel mutation, p.Asn549Ser, and new cases of p.Asn549His and p.Asn549Thr mutations, each reported once before. Our three cases of Asn-549 mutations, alongside with rare previously reported cases, show that these patients are at higher risk of hydrocephalus. Clinical and imaging follow-up, with possible early surgery, may help prevent secondary intellectual disability.

Objective: Several significant midline abnormalities including cavum septum pellucidum (CSP) have been reported in schizophrenia. However, not all studies were able to replicate similar findings. Furthermore, very few of them were conducted with large samples. Methods: CSP was identified and graded with 16 slice computed tomography (CT) machine in 138 patients of schizophrenia and 64 controls. Results: We found 21.0% of patients in schizophrenia group had abnormal CSP compared to only 9.4% in control group (P = 0.047). Grade III was most frequent type (19.6%) in schizophrenia group. Conclusions: Our study adds to the existing literature suggesting abnormal CSP may reflect neurodevelopmental process in schizophrenia. The strength of our study was larger sample size. Limitations were use of CT, male predominance in schizophrenia group, the inclusion of nonpsychiatric patients in control group.

El septum pellucidum es un fino tabique formado por dos láminas gliales dispuestas entre el cuerpo calloso en dirección cefálica y el trígono ubicado caudalmente. Durante la vida embrionaria existen variantes anatómicas del septum pellucidum que se disponen en sentido rostro-dorsal. Estas son el cavum del septum pellucidum, el cavum vergae y el cavum velum interpositum. Su presencia o ausencia puede estar relacionada con alteraciones del desarrollo del sistema nervioso y trastornos cognitivo-psiquiátricos, por lo que deben conocerse bien para evitar diagnósticos erróneos.

Purpose: The purpose of this study is to describe the morphological characteristics of fetal MRIs and outcome of prenatally-detected abnormal width of the CSP (cavum septum pellucidum).Material and Methods: A retrospective study of cases with abnormal width of the CSP demonstrated prenatally on MRI. Data collected included: prenatal history, MRI features, sonographic follow up, and neurodevelopmental outcome.Results: Most of the cases referred (34/39) had an abnormal CSP on MRI. Thirty cases had an abnormal width: 23 had narrow CSP and seven had wide CSP. Only three out of 12 cases that were referred with US diagnosis of absent CSP were confirmed by MRI, the rest had narrow CSP. Follow up was performed in 24 out of 30 cases with an abnormal CSP width; all had normal neurodevelopment.Conclusion: To the best of our knowledge, this is the first study to examine the outcome in narrow and wide CSPs detected prenatally. An abnormal width of the CSP prenatally, without an associated fetal abnormality such as aneuploidy, appears to have normal outcome. MRI should be offered when an absence of the CSP is suspected on US to rule out narrow CSP, which seems to be a benign finding. [ABSTRACT FROM AUTHOR]

Colloid cyst is a rare benign intracranial lesion. Due to its embryologic origin and development, it is commonly located within the third ventricle, though it also presents at various locations. Its location within cavum septum pellucidum is rarely reported. Operative approaches to such lesion can be challenging and misleading due to intraoperative variations. However, surgical resection in such locations are simplified and perfected with stereotactic guidance. A case of colloid cyst within the cavum septum pellucidum and the importance of stereotactic guidance in precisely reaching the lesion, thus minimizing the dissection of corpus callosum, are discussed. [ABSTRACT FROM AUTHOR]

Cavum septum pellucidum (CSP) is a neuroanatomical variant of the septum pellucidum that is considered a marker for disrupted brain development. Several small sample studies have reported CSP to be related to disruptive behavior, persistent antisocial traits, and even psychopathy. However, no large-scale samples have comprehensively examined the relationship between CSP, psychopathic traits, and antisocial behavior in forensic samples. Here we test hypotheses about the presence of CSP and its relationship to psychopathic traits in incarcerated males ( N  = 1432). We also examined the incidence of CSP in two non-incarcerated male control samples for comparison ( N  = 208 and 125). Ethnic and racial composition was varied with a mean age of 33.1, and an average IQ of 96.96. CSP was evaluated via structural magnetic resonance imaging. CSP was measured by length (number of 1.0 mm slices) in continuous analyses, and classified as absent (0) or present (1+ mm), as well as by size (absent (0), small (1–3), medium (4–5), or large (6+ mm)) for comparison with prior work. The Wechsler Adult Intelligence Scale (WAIS-III), Structured Clinical Interview (SCID-I/P), and Hare Psychopathy Checklist-Revised (PCL-R) were used to assess IQ, substance dependence, and psychopathy, respectively. CSP length was positively associated with PCL-R total, Factor 1 (interpersonal/affective) and Facets 1 (interpersonal) and 2 (affective). CSP was no more prevalent among inmates than among non-incarcerated controls, with similar distributions of size. These results support the hypotheses that abnormal septal/limbic development may contribute to dimensional affective/interpersonal traits of psychopathy, but CSP is not closely associated with antisocial behavior, per se. [ABSTRACT FROM AUTHOR]

This study used oculomotor, cognitive, and multi-modal magnetic resonance imaging (MRI) measures to assess for neurological abnormalities in current asymptomatic amateur Australian rules footballers (i.e., Australia's most participated collision sport) with a history of sports-related concussion (SRC). Participants were 15 male amateur Australian rules football players with a history of SRC greater than 6 months previously, and 15 sex-, age-, and education-matched athlete control subjects that had no history of neurotrauma or participation in collision sports. Participants completed a clinical interview, neuropsychological measures, and oculomotor measures of cognitive control. MRI investigation involved structural imaging, as well as diffusion tensor imaging and resting-state functional MRI sequences. Despite no group differences on conventional neuropsychological tests and multi-modal MRI measures, Australian rules football players with a history of SRC performed significantly worse on an oculomotor switch task: a measure of cognitive control that interleaves the response of looking towards a target (i.e., a prosaccade) with the response of looking away from a target (i.e., an antisaccade). Specifically, Australian footballers performed significantly shorter latency prosaccades and found changing from an antisaccade trial to a prosaccade trial (switch cost) significantly more difficult than control subjects. Poorer switch cost was related to poorer performance on a number of neuropsychological measures of inhibitory control. Further, when comparing performance on the cognitively more demanding switch task with performance on simpler, antisaccade/prosaccades tasks which require a single response, Australian footballers demonstrated a susceptibility to increased cognitive load, compared to the control group who were unaffected. These initial results suggest that current asymptomatic amateur Australian rules football players with a history of SRC may have persisting, subtle, cognitive changes, which are demonstrable on oculomotor cognitive measures. Future studies are required in order to further elucidate the full nature and clinical relevance of these findings. [ABSTRACT FROM AUTHOR]

Background: Cavum septum pellucidum (CSP) and cavum vergae are actually fluid-filled, generally communicating midline cavities located between the third ventricle and corpus callosum. There have been various reports of their association with many behavioral and psychiatric disorders. Infrequently, they have been associated with an obstructive hydrocephalus-like picture. Although the structure and management of CSP has long been known, it has been an enigma as far as functional significance and management indications are concerned. The authors of this article try to analyze the significance of a persistent cavum and involvement of the same entity in varied presentations ranging from an incidental imaging finding to acute hydrocephalus, and propose a possible implication on the present surgical intervention paradigm. Purpose: To assess the surgical outcome of fenestration of a CSP cyst. Methods: Retrospective analysis of 3 patients who underwent endoscopic fenestration for CSP with obstructive hydrocephalus between 2012 and 2014 was done, and data were analyzed for symptomatic clinical improvement in particular behavior. Results: Pre- and postoperative brain MRI showed a significant decrease in the size of the cyst as well as the ventricles. There were no recurrences during follow-up. All of the patients improved. Conclusions: (1) Endoscopic fenestration of symptomatic CSP cysts is a safe treatment option. (2) Neurocognitive assessment is essential in the evaluation and outcome assessment of CSP. [ABSTRACT FROM AUTHOR]

Background Posterior third ventricular lesions often cause obstructive hydrocephalus. Thus, a combined endoscopic third ventriculostomy (ETV) and endoscopy biopsy are often the first treatment. However, the trajectories for both procedures can differ significantly, necessitating 2 entry points or a combined rigid-flexible technique. Methods We describe the use of a large cavum septum pellucidum as a route for performing the biopsy. Results Using a rigid endoscope and a single trajectory, we were able to perform a transforaminal ETV and a transseptal, transcaval, interforniceal biopsy of the tumor. Conclusion Although described as a route to reach the anterior third ventricle endoscopically, we describe the use of the transseptal, transcaval, interforniceal approach to reach the posterior part of the third ventricle. [ABSTRACT FROM AUTHOR]

Transitory cavities associated with the ventricular system represent probably one of the most unique features in the developing mammalian brain. In rodents, the cavities exist transiently in the developing brain and do not appear to be associated with any pathological events. Among the various cavities, the pyramidal-shaped cavum septum pellucidum (CSP) located beneath the corpus callosum and between the lateral ventricles is most well defined. In addition to the CSP are the bilateral subependymal cysts that are consistently associated with the third and fourth ventricles as well as the aqueduct. The cavities/cysts contain a large number of amoeboid microglia expressing surface receptors and hydrolytic enzymes common to tissue macrophages. The significance of these cavities in the developing brain remains a conjecture. Firstly, the cavity walls are free of an apparent epithelial lining; hence, it is speculated that the cavities that appear to communicate with the widened neighboring interstitial tissue spaces may have resulted from physical traction due to the rapid growth of the perinatal brain. Secondly, the cavities contain prominent clusters of amoeboid microglia that may be involved in clearing the debris of degenerating axons and cells resulting from the early brain tissue remodeling. With the increase in brain tissue compactness following the beginning of myelination in the second postnatal week, all cavities are obliterated; concomitantly, the number of amoeboid microglia in them diminishes and all this might signal further maturation of the brain. [ABSTRACT FROM AUTHOR]

Cavum septum pellucidum (CSP) is a neurodevelopmental anomaly, which is commonly reported in schizophrenia patients. Various symptoms of schizophrenia, including thought disturbances have been associated with CSP. We present a rare case of undifferentiated schizophrenia with CSP who presented with self-mutilating behaviors.

Fetal alcohol spectrum disorders (FASD) include physical and neurodevelopmental abnormalities related to prenatal alcohol exposure. Some neuroimaging findings have been clearly related to FASD, including corpus callosum and cerebellar anomalies. However, detailed studies correlating with specific FASD categories, that is, the fetal alcohol syndrome (FAS), partial FAS (pFAS) and alcohol related neurodevelopmental disorders (ARND), are lacking. We prospectively performed clinical assessment and brain MR imaging to 72 patients with suspected FASD, and diagnosis was confirmed in 62. The most frequent findings were hypoplasia of the corpus callosum and/or of the cerebellar vermis. Additional findings were vascular anomalies, gliosis, prominent perivascular spaces, occipito-cervical junction and cervical vertebral anomalies, pituitary hypoplasia, arachnoid cysts, and cavum septum pellucidum. [ABSTRACT FROM AUTHOR]

Fetal alcohol spectrum disorders (FASD) cause neurodevelopmental abnormalities. However, publications about epilepsy and electroencephalographic features are scarce. In this study, we prospectively performed electroencephalography (EEG) and brain magnetic resonance (MR) imaging in 61 patients with diagnosis of FASD. One patient had multiple febrile seizures with normal EEGs. Fourteen children showed EEG anomalies, including slow background activity and interictal epileptiform discharges, focal and/or generalized, and 3 of them had epilepsy. In one patient, seizures were first detected during the EEG recording and one case had an encephalopathy with electrical status epilepticus during slow sleep (ESES). Focal interictal discharges in our patients did not imply the presence of underlying visible focal brain lesions in the neuroimaging studies, such as cortical dysplasia or polymicrogyria. However, they had nonspecific brain MR abnormalities, including corpus callosum hypoplasia, vermis hypoplasia or cavum septum pellucidum. The latter was significantly more frequent in the group with EEG abnormal findings (p < 0.01). [ABSTRACT FROM AUTHOR]

Mutations in Fibroblast Growth Factor Receptor II (FGFR2) have been identified in patients with Crouzon and Pfeiffer syndrome, among which rare mutations of the intracellular tyrosine kinase domain. Correlating subtle phenotypes with each rare mutation is still in progress. In Necker-Enfants Malades Hospital, we identified three patients harboring three different pathogenic variants of the same amino acid residue Asn-549 located in this domain: in addition to a very typical crouzonoid appearance, they all developed clinically relevant hydrocephalus, which is an inconstant feature of Crouzon and Pfeiffer syndrome. Overall, FGFR2 tyrosine kinase domain mutations account for 5/67 (7.4%) cases in our hospital. We describe a novel mutation, p.Asn549Ser, and new cases of p.Asn549His and p.Asn549Thr mutations, each reported once before. Our three cases of Asn-549 mutations, alongside with rare previously reported cases, show that these patients are at higher risk of hydrocephalus. Clinical and imaging follow-up, with possible early surgery, may help prevent secondary intellectual disability. [ABSTRACT FROM AUTHOR]

Objective: Several significant midline abnormalities including cavum septum pellucidum (CSP) have been reported in schizophrenia. However, not all studies were able to replicate similar findings. Furthermore, very few of them were conducted with large samples. Methods: CSP was identified and graded with 16 slice computed tomography (CT) machine in 138 patients of schizophrenia and 64 controls. Results: We found 21.0% of patients in schizophrenia group had abnormal CSP compared to only 9.4% in control group (P = 0.047). Grade III was most frequent type (19.6%) in schizophrenia group. Conclusions: Our study adds to the existing literature suggesting abnormal CSP may reflect neurodevelopmental process in schizophrenia. The strength of our study was larger sample size. Limitations were use of CT, male predominance in schizophrenia group, the inclusion of nonpsychiatric patients in control group. [ABSTRACT FROM AUTHOR]

The absence of the adhesio interthalamica (AI; also called interthalamic adhesion or massa intermedia) and the presence of a large cavum septum pellucidum (CSP) later in life have been related to neurodevelopmental alterations and have not been systematically investigated in epilepsy to date. This study carried out a MRI evaluation of the AI and CSP in a large sample with mesial temporal lobe epilepsy (MTLE). A total of 179 patients, classified according to the side of the epileptogenic focus, and 156 age- and sex-balanced healthy controls were assessed. Between-group comparisons of the prevalence and length of both AI and CSP were conducted. Neuropsychological assessments were also performed in 160 MTLE patients. The patients exhibited reduction in the AI prevalence (P < 0.05; FDR-uncorrected) and length (P < 0.05; FDR-corrected) when compared to controls. Patients without AI showed lower scores in a proportion of neuropsychological tests than patients with AI. No CSP differences were found between MTLE patients and controls. These results support that AI anomalies have clinical significance in MTLE, as well as indicate that neurodevelopmental alterations may be implicated in this disorder. [ABSTRACT FROM AUTHOR]

Panic disorder is thought to involve dysfunction in the septohippocampal system, and the presence of a cavum septum pellucidum might indicate the aberrant development of this system. We compared the prevalence and size of cavum septum pellucidum in 21 patients with panic disorder and in 21 healthy controls by magnetic resonance imaging. The length of the cavum septum pellucidum was measured by counting the number of consecutive 1-mm coronal slices in which it appeared. A cavum septum pellucidum of >6 mm in length was rated as large. There was no significant difference in the proportion of patients (16 of 21 or 76.2%) and controls (18 of 21 or 85.7%) with a cavum septum pellucidum (P = 0.35, Fisher's exact test, one-tailed), and no members of either group had a large cavum septum pellucidum. The mean cavum septum pellucidum rating in the patient and control groups was 1.81 (SD = 1.50) and 2.09 (SD = 1.51), respectively. There were also no significant differences between groups when we analyzed cavum septum pellucidum ratings as a continuous variable (U = 196.5; P = 0.54). Across all subjects there was a trend towards a higher prevalence of cavum septum pellucidum in males (100%, 10 of 10) than females (75%, 24 of 32; P = 0.09, Fisher's exact test, one-tailed). Thus, we conclude that, while panic disorder may involve septo-hippocampal dysfunction, it is not associated with an increased prevalence or size of the cavum septum pellucidum.

Colloid cysts (CC) occur predominantly in the midline with majority involving roof of the third ventricle. In cases of cavum septum pellucidum (CSP), the surgeon can lose orientation when normal intraventricular structures are not encountered during surgery. We report a patient with CSP, who underwent right frontal parasagittal craniotomy, interhemispheric, transcallosal approach to reach the lesion. Lesion may not be seen in its usual location of foramen of Monroe, and entering the cavum may be confusing because no intraventricular landmarks will be seen. Excision of the cyst through the cavum usually requires interfornicial approach, and this structure must be separated gently to avoid injury. [ABSTRACT FROM AUTHOR]

The cavum septum pellucidum (CSP) is an important fetal midline forebrain landmark, and its absence often signifies additional underlying malformations. Frequently detected by prenatal sonography, absence of the CSP requires further imaging with pre- or postnatal MRI to characterize the accompanying abnormalities. This article reviews the developmental anatomy of the CSP and the pivotal role of commissurization in normal development. An understanding of the patterns of commissural abnormalities associated with absence of the CSP can lead to improved characterization of the underlying spectrum of pathology. [ABSTRACT FROM AUTHOR]