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Patients with mental diseases have an increased prevalence of abnormalities in midline brain structures. One of these abnormalities is the cavum septum pellucidum (CSP), which occurs when the septum pellucidum fails to fuse. The detection and study of these brain abnormalities in Magnetic Resonance Imaging requires a tedious and time-consuming process of manual image analysis. It is also problematic when the same abnormality is analyzed manually by different experts because different criteria can be applied. In this context, it would be useful to develop an automatic method for locating the abnormality and give the measure of its depth. In this work, we explore, for the first time in the literature, an automated detection method based on CNNs. In particular, we compare different CNN models and classical machine learning classification algorithms to face this problem on a dataset of 861 subjects (639 patients with mood or psychotic disorders and 223 healthy controls) and obtain very promising results, reaching over 99% of accuracy, sensitivity and specificity.

Although millions of individuals suffer a traumatic brain injury (TBI) worldwide each year, it is only recently that TBI has been recognized as a major public health problem. Beyond the acute clinical manifestations, there is growing recognition that a single severe TBI (sTBI) or repeated mild TBIs (rTBI) can also induce insidious neurodegenerative processes, which may be associated with early dementia, in particular chronic traumatic encephalopathy (CTE). Identified at autopsy examination in individuals with histories of exposure to sTBI or rTBI, CTE is recognized as a complex pathology featuring both macroscopic and microscopic abnormalities. These include cavum septum pellucidum, brain atrophy and ventricular dilation, together with pathologies in tau, TDP-43, and amyloid-β. However, the establishment and characterization of CTE as a distinct disease entity is in its infancy. Moreover, the relative “dose” of TBI, such as the frequency and severity of injury, associated with risk of CTE remains unknown. As such, there is a clear and pressing need to improve the recognition and diagnosis of CTE and to identify mechanistic links between TBI and chronic neurodegeneration.

The cavum septum pellucidum (CSP) is a normal variant fluid potential space of CSF density (on CT) and signal intensity (on MRI). A CSP may simulate a cystic lesion and can occasionally even appear to cause mass effect or can be confused with hydrocephalus. Three general variations of the septum pellucidum exist: the standard cavum septum pellucidum (CSP), the cavum septum pellucidum et vergae (CEV), and the cavum velum interpositum (CVI). To understand the difference between these three variations, a brief description of the anatomy and embryology is necessary. The normal septum pellucidum consists of two leaflets/septations of white matter that are separated in nearly all fetuses in utero. Typically, these septations (i.e., septi pellucidi) fuse in the posterior to anterior direction soon before or after the neonatal period, especially by adulthood. Thus, the CSP exists when the two leaves fail to fuse; it is situated somewhere posterior to the genu of the corpus callosum but anterior to the columns of the fornix.

1. VGAMs: Definition, the FALSE answer is: A. The anatomic landmark of a VGAM is the presence of multiple arteriovenous shunts draining into a dilated median prosencephalic vein. B. True VGAM are mainly fed from the choroidal and other surrounding arteries. C. Are defined as arteriovenous fistulas in the choroid fissure supplied by the choroidal arteries and draining to the dilated median prosencephalic vein. D. Are defined as arteriovenous fistulas in the wall of a persistent embryonic vascular channel called the median prosencephalic vein. E. The median prosencephalic vein is an embryonic vessel normally present at the adult stage.

Familiarity with the normal brain anatomy and its age-dependent normal variation/evolution is essential for proper interpretation of neonatal head ultrasonography studies. In a preterm neonate, the brain surface is smooth, while a complex gyration and sulcation pattern is expected in term neonates. In newborns, persistent fetal fluid-filled spaces such as the cavum septum pellucidum, cavum Vergae, and cavum veli interpositi, asymmetry in size of the lateral ventricles, and variable morphology of the choroid plexus are physiological.

As we have already seen, acrania is generally diagnosed in the first trimester, but should no ultrasound examination have been performed in the first trimester, the sonographer may be faced with the classic image of the “reptilian” face (Fig. 7.1).