Abstract
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.
Highlights
Cavum septum pellucidum (CSP) is a common incidental finding, defined as a midline cerebrospinal fluid (CSF) space delimited superiorly by the crus of the fornices and inferiorly by the tela choroidea of the third ventricle [1]
There is no consensus about the management of symptomatic CSP and cavum vergae (CV) cysts, and various procedures have been proposed [1, 3–5, 8, 11–13]
The aim of the present study is to review the preoperative characteristics, surgical procedures, and postoperative outcome of symptomatic CSP and CV cysts treated surgically and reported in the literature
Summary
Cavum septum pellucidum (CSP) is a common incidental finding, defined as a midline cerebrospinal fluid (CSF) space delimited superiorly by the crus of the fornices and inferiorly by the tela choroidea of the third ventricle [1]. It is anatomically distinct from cavum vergae (CV) which is a CSF space extending posteriorly to the columns of the fornix. CSP and CV cysts are used interchangeably in the literature and may coexist in many cases [1–5]. The aim of the present study is to review the preoperative characteristics, surgical procedures, and postoperative outcome of symptomatic CSP and CV cysts treated surgically and reported in the literature
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