Anterior Transcallosal Interforniceal Approach to the Third Ventricle via a Cavum Septum Pellucidum and Cavum Vergae

Abstract BACKGROUND AND IMPORTANCE 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. CLINICAL PRESENTATION 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. CONCLUSION 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.

Download Full-text

Excision of Colloid Cyst through Interhemispheric, Transcallosal, Transcavum, Interfornicial Approach

Indian Journal of Neurosurgery ◽

10.1055/s-0039-3400208 ◽

2021 ◽

Author(s):

Santosh Kumar ◽

Nishanth Sadashiva

Keyword(s):

Third Ventricle ◽

Colloid Cyst ◽

Septum Pellucidum ◽

Cavum Septum Pellucidum ◽

Transcallosal Approach ◽

The Third ◽

Usual Location ◽

Colloid Cysts

AbstractColloid 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.

Download Full-text

Frame-Based Stereotactic-Guided Excision of Colloid Cyst of Cavum Septum Pellucidum through Transcallosal Approach—A Technical Note

Indian Journal of Neurosurgery ◽

10.1055/s-0037-1606825 ◽

2017 ◽

Vol 07 (03) ◽

pp. 235-238

Author(s):

J. Parthiban ◽

S. Shanthanam ◽

R. Manivasagam

Keyword(s):

Corpus Callosum ◽

Third Ventricle ◽

Colloid Cyst ◽

Technical Note ◽

Septum Pellucidum ◽

Cavum Septum Pellucidum ◽

Intracranial Lesion ◽

Transcallosal Approach ◽

The Third ◽

Stereotactic Guidance

AbstractColloid 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.

Download Full-text

Spontaneous Resolution of Cavum Veli Interpositi

The Neuroradiology Journal ◽

10.1177/197140090802100609 ◽

2008 ◽

Vol 21 (6) ◽

pp. 805-809

Author(s):

S. Vattoth ◽

Y.S. Kim ◽

E. Norman ◽

G.H. Roberson

Keyword(s):

Case Reports ◽

Third Ventricle ◽

Septum Pellucidum ◽

Spontaneous Resolution ◽

Cerebral Veins ◽

Cavum Septum Pellucidum ◽

Internal Cerebral Veins ◽

Cavum Veli Interpositi ◽

Quadrigeminal Plate ◽

Forward Extension

Cavum veli interpositi is an open CSF space in the roof of the third ventricle that surrounds the internal cerebral veins, and is a forward extension of the quadrigeminal plate cistern. To the best of our knowledge, spontaneous resolution of a cavum veli interpositi has not been reported in the literature to date. Interestingly, case reports of spontaneous resolution of cystic cavum septum pellucidum in three patients and eighteen arachnoid cyst cases has been described in the literature. We describe the spontaneous resolution of a cavum veli interpositi or cyst in cavum veli interpositi in a 35-year-old man and review the literature of spontaneous resolution of cavum septum pellucidum and arachnoid cysts.

Download Full-text

Association of Cavum Septum Pellucidum and Cavum Vergae With Cognition, Mood, and Brain Volumes in Professional Fighters

JAMA Neurology ◽

10.1001/jamaneurol.2019.2861 ◽

2020 ◽

Vol 77 (1) ◽

pp. 35 ◽

Cited By ~ 2

Author(s):

Jonathan K. Lee ◽

Jenny Wu ◽

Jennifer Bullen ◽

Sarah Banks ◽

Charles Bernick ◽

...

Keyword(s):

Septum Pellucidum ◽

Brain Volumes ◽

Cavum Septum Pellucidum ◽

Cavum Vergae

Download Full-text

Cavum velum interpositum, cavum septum pellucidum and cavum Vergae: a review

Child s Nervous System ◽

10.1007/s00381-011-1565-z ◽

2011 ◽

Vol 27 (12) ◽

pp. 2027-2028 ◽

Cited By ~ 2

Author(s):

Maciej K. Ciołkowski

Keyword(s):

Septum Pellucidum ◽

Cavum Septum Pellucidum ◽

Cavum Vergae ◽

Velum Interpositum

Download Full-text

Cavum Septum Pellucidum, da embriologia à clínica: uma revisão da literatura

Journal of Health & Biological Sciences ◽

10.12662/2317-3076jhbs.v7i1.2200.p89-96.2019 ◽

2018 ◽

Vol 7 (1) ◽

pp. 89

Author(s):

Lia Pontes Lisboa Martins ◽

Antônio Miguel Furtado Leitão ◽

Jalles Dantas de Lucena ◽

Francisco de Assis Aquino Gondim

Keyword(s):

Septum Pellucidum ◽

Cavum Septum Pellucidum ◽

Cavum Vergae

Introdução: O septo pelúcido (SP) é formado por duas lâminas neurais separadas, que se fundem após o nascimento. Quando não há fusão completa, tem-se a persistência do Cavum embriológico, que pode ser chamado Cavum Septum pellucidum (CSP), Cavum Vergae ou Cavum Septum pellucidum et Vergae (CSP et Vergae), dependendo da extensão anteroposterior. Embriologicamente, o CSP está relacionado à formação do corpo caloso e de outras estruturas cerebrais. O SP faz parte do sistema límbico, por isso há possibilidade de que Cava persistentes tenham repercussão nas funções neuropsíquicas. Objetivo: revisar a literatura sobre a formação e o significado clínico da persistência do CSP em adultos. Métodos: foi realizada revisão da literatura de artigos publicados na base de dados PUBMED, utilizando os descritores: “Cavum”, “Brain Cava” e “Cavum Septum Pellucidum”. Os artigos selecionados continham considerações sobre formação e possível significado clínico do CSP. Resultados e Discussão: CSP vestigiais são considerados como variantes da normalidade. Porém, vários estudos sugerem que a persistência de CSP com grandes dimensões pode representar uma disgenesia cerebral na linha média. Estudos tentam relacionar o CSP com múltiplos distúrbios neuropsiquiátricos, especialmente com esquizofrenia. De maneira geral, há relativo consenso de que os CSP alargados têm maior chance de representar significado patológico, embora suas manifestações não sejam bem reconhecidas. Conclusão: existem indícios de que CSP persistentes, quando alargados, podem manifestar-se como distúrbio neuropsíquico, de espectro ainda indefinido. Estudos em população geral ainda são escassos e com prevalências variadas. Trabalhos mais abrangentes são necessários para melhor entendimento de seu significado clínico.

Download Full-text