Cavum Vergae Cyst Research Articles

Endoscopic Fenestration of Cavum Septum Pellucidum Cysts to the Third Ventricle: Technical Note.

Cavum septum pellucidum (CSP) and cavum vergae (CV) cysts are common incidental findings on imaging studies. However, they may rarely present with symptoms related to the obstruction of the foramen of Monro by the cyst leaflets. There is no consensus regarding the management of symptomatic CSP and CV cysts. We present an original transcavum interforniceal endoscopic fenestration technique. The step-by-step surgical procedure and two illustrative cases are presented. A 31-yr-old male and a 24-yr-old woman presented with symptomatic CSP and CV cysts. For both patients, neuronavigation was used to plan the procedure. An endoscope was introduced into the cyst through a right frontal burr-hole. After an examination of the endoscopic anatomy, a communication between the cyst and the third ventricle was performed using an endoscopic forceps. In both cases, directly after the fenestration, cerebrospinal fluid (CSF) passed through the communication, and the collapse of the cyst was appreciated. Symptoms were relieved in both patients, and neuropsychological assessment improved. Postoperative imaging showed a reduction in the cyst bulge, and patent foramen of Monro. Endoscopic fenestration of CSP and CV cysts to the third ventricle through an interforniceal navigated approach is a feasible and efficient surgical procedure. Theoretical advantages include a single tract through noneloquent brain, a perpendicular trajectory to the membrane for fenestration, and a large CSF space beyond the fenestration point.

EP08.14: Prenatal diagnosis and outcome of a cavum vergae cyst: a case report

EP08.14: Prenatal diagnosis and outcome of a cavum vergae cyst: a case report

Arachnoid cyst of the cavum velum interpositum associated with cavum septum pellucidum and cavum vergae

A cavum velum interpositum is a normal variaton which is often detected incidentally in asymptomatic individuals. However, arachnoid cyst of the cavum velum interpositum is extremely rare and may cause symptoms similar to those of a third ventricular mass. On imaging, the main differentials of this cyst are; cystic dilatation of the cavum velum interpositum, cavum vergae cyst, arachnoid cyst of the quadrigeminal cistern, and epidermoid cyst. We present a case of an arachnoid cyst of the cavum velum interpositum coincidentally associated with the cavum septum pellusidum and cavum vergae. The cavum velum interpositum is a rare location for the arachnoid cysts. Accurate diagnosis of the arachnoid cysts of the cavum velum interpositum is important as they cause serious symptoms which can be reversed by surgical treatment.

Diagnóstico de cavum vergae durante el tercer trimestre de gestación

Los quistes intracraneales de la línea media anterior se pueden encontrar en tres formas: cavum septum pellucidum, cavum vergae y cavum velum interpositum. El cavum vergae es una extensión del cavum septum pellucidum en dirección posterior a las columna del fórnix y el foramen de Monro. Aunque no está presente en todos los fetos, cuando se observa durante la evaluación ecográfica prenatal puede ser mal diagnosticado como un quiste de la línea inter-hemisférica con pronóstico incierto. Se presenta un caso de una embarazada de 18 años quien acudió a la consulta prenatal a las 32 semanas. Durante la evaluación ecográfica se halló una lesión quística eco-negativa de 20 x 12 milímetros de diámetro, rectangular, intracraneal, presencia de cuerpo calloso y sin evidencia de hidrocefalia compresiva. El cariotipo fue normal. Se consideró el diagnóstico de quiste del cavum vergae. Se obtuvo un recién nacido normal posterior a parto vaginal espontáneo. La resonancia magnética después del parto confirmó el diagnostico.

Genel Anestezi Altında Septoplasti ve Adenoidektomi Operasyonundan Sonra Tanı Konulan Cavum Septum Pellusidum

Cavum septi pellucidi (CSP), cavum vergae (CV) and cavum veli interpositi (CVİ), which are congenital midline brain cysts which are rare, and still have controversial etiologies, developments and treatments. In this paper, it was aimed to introduce the case of detecting CSP cysts and applying medical treatment for the patients who developed loss of consciousness and loss of power in the left limbs, 6 hours after a septoplasty and adenoidectomy. As a result; One should take into account that CSP and CV cysts sometimes could become symptomatic, acute cerebrovascular events could occur during and after the surgical intervention, so that the one should be careful regarding the management of anaesthesia.

Intracranial Migration of Bone Dust After Intraventricular Neuroendoscopy Complicating Acute Hydrocephalus and Removal of Bone Dust

To present the first case of neuroendoscopic removal of migrated intraventricular bone dust and gel foam after intraventricular endoscopic surgery. A 37-year-old man was admitted with a 2-year history of headache. Brain computed tomography (CT) scan and magnetic resonance imaging revealed a cavum vergae cyst. The patient was operated on by stereotactically guided endoscopic cyst fenestration with no intraoperative complications. Postoperative CT scan demonstrated regression of the cyst with no other pathological findings. Because of a postoperative fever, a lumbar puncture was performed after the brain CT scan to eliminate meningitis as a differential diagnosis. After the lumbar puncture, the patient complained of severe headache and vomiting followed by depression of consciousness. The follow-up CT scan showed the migration of bone dust from the burr hole site to the ventricular system and acute hydrocephalus. It is thought that the negative pressure gradient generated after the lumbar puncture might have been transmitted through the cerebrospinal fluid pathway, resulting in a suction effect and migration of the bone dust from the burr hole to the ventricle. An urgent reexplorative endoscopic procedure was performed, and most of the bone dust and gel foam were removed. The patient recovered with complete resolution of the previous symptoms. We propose not using autologous bone dust for closure of the burr holes after endoscopic intraventricular procedures; instead, alloplastic materials designed especially for burr hole closure may be used. However, our main recommendation is to use an external ventricular drainage, which is maintained closed but can be opened if necessary. In addition, lumbar puncture should be avoided in cases in which bone dust is used for the burr hole reconstruction without dural closure.

Neuroendoscopic Management of Symptomatic Septum Pellucidum Cavum Vergae Cyst Using a High-Definition Flexible Endoscopic System -Case Report-

A 24-year-old man, who had an asymptomatic septum pellucidum cyst incidentally found one year previously, presented with severe headache and right abducens nerve palsy caused by expansion of the midline cyst. Preoperative magnetic resonance (MR) imaging revealed obstructive hydrocephalus due to the enlarged midline cyst. Neuroendoscopic fenestration of the septum pellucidum cyst was successfully performed via a right frontal approach using a high-resolution flexible neuroendoscopic system without complication. Communication between the cyst cavity and bilateral lateral ventricles was constructed via a single trajectory. The entire inner cyst wall could be inspected from the cyst cavity by manipulating the flexible neuroendoscopic system, which excluded the presence of neoplasm. His symptoms were completely relieved after surgery, and postoperative MR imaging showed significant improvement of hydrocephalus and shrinkage of the midline cyst. Septum pellucidum cavum vergae cyst may expand and become symptomatic, so fenestration using a flexible neuroendoscope system may be the optimal method for constructing communication to the bilateral lateral ventricles with minimal invasion.