Cavum septi pellucidi, cavum vergae and cavum veli interpositi

Authors: O. Krejčí 1;  T. Krejčí 1,2;  P. Vacek 3;  M. Chlachula 1;  R. Lipina 1,2
Authors‘ workplace: Neurochirurgická klinika FN Ostrava 1;  LF OU, Ostrava 2;  Neurochirurgická klinika, LF UK a FN Plzeň 3
Published in: Cesk Slov Neurol N 2020; 83(2): 166-172
Category: Review Article
doi: 10.14735/amcsnn2020166


Cavum septi pellucidi, cavum vergae and cavum veli interpositi are anterior midline intracranial findings which are typically incidental and are usually developmentally obliterated during postnatal life. Symptomatic and abnormally expanded cavities that do not have free communication with the lateral ventricles are called cysts. This review focuses on the embryology, anatomy, epidemiology, clinical symptomatology, radiological findings and treatment of these rare conditions.


endoscopy – hydrocephalus – septum pellucidum – velum interpositum – cavum vergae


1. Shaw CM, Alvord EC. Cava septi pellucidi et vergae: their normal and pathogical states. Brain J Neurol 1969; 92 (1): 213–223.

2. Yokota A. Cysts originating from a defect in the hemispheric cleavage (cavum septi pellucidi, cavum vergae, cavum veli interpositi). In: Raimondi AJ, Choux M, Di Rocco C (eds). Intracranial cyst lesions. New York: Springer 1993: 87–99.

3. Krejčí T, Vacek P, Krejčí O et al. Symptomatic cysts of the cavum septi pellucidi, cavum vergae and cavum veli interpositi: a retrospective duocentric study of 10 patients. Clin Neurol Neurosurg 2019; 185: 105494. doi: 10.1016/j.clineuro.2019.105494.

4. Sarwar M. The septum pellucidum: normal and abnormal. AJNR Am J Neuroradiol 1989; 10 (5): 989–1005.

5. Lancon JA, Haines DE, Raila FA et al. Expanding cyst of the septum pellucidum. Case report. J Neurosurg 1996; 85 (6): 1127–1134. doi: 10.3171/jns.1996.85.6.1127.

6. Donati P, Sardo L, Sanzo M et al. Giant cyst of the cavum septi pellucidi, cavum Vergae and veli interpositi. Minim Invasive Neurosurg 2003; 46 (3): 177–181. doi: 10.1055/s-2003-40732.

7. Cho ZH, Chi JG, Choi ZH et al. A newly identified frontal path from fornix in septum pellucidum with 7.0 T MRI track density imaging (TDI) – the septum pellucidum tract (SPT). Front Neuroanat 2015; 9: 151. doi: 10.3389/fnana.2015.00151.

8. Donauer E, Moringlane JR, Ostertag CB. Cavum vergae cyst as a cause of hydrocephalus, “almost forgotten”? Successful stereotactic treatment. Acta Neurochir (Wien) 1986; 83 (1–2): 12–19. doi: 10.1007/bf01420502.

9. Tubbs RS, Krishnamurthy S, Verma K et al. Cavum velum interpositum, cavum septum pellucidum, and cavum vergae: a review. Childs Nerv Syst 2011; 27 (11): 1927–1930. doi: 10.1007/s00381-011-1457-2.

10. Nakano S, Hojo H, Kataoka K et al. Age related incidence of cavum septi pellucidi and cavum vergae on CT scans of pediatric patients. J Comput Assist Tomogr 1981; 5 (3): 348–349. doi: 10.1097/00004728-198106000-00006.

11. Chen JJ, Chen CJ, Chang HF et al. Prevalence of cavum septum pellucidum and/or cavum Vergae in brain computed tomographies of Taiwanese. Acta Neurol Taiwanica 2014; 23 (2): 49–54.

12. Tong CK, Singhal A, Cochrane DD. Endoscopic fenestration of cavum velum interpositum cysts: a case study of two symptomatic patients. Childs Nerv Syst 2012; 28 (8): 1261–1264. doi: 10.1007/s00381-012-1770-4.

13. Wang L, Ling SY, Fu XM et al. Neuronavigation-assisted endoscopic unilateral cyst fenestration for treatment of symptomatic septum pellucidum cysts. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (4): 209–215. doi: 10.1055/s-0032-1331385.

14. Gangemi M, Maiuri F, Cappabianca P et al. Endoscopic fenestration of symptomatic septum pellucidum cysts: three case reports with discussion on the approaches and technique. Minim Invasive Neurosurg 2002; 45 (2): 105–108. doi: 10.1055/s-2002-32483.

15. Corsellis JA, Bruton CJ, Freeman-Browne D. The aftermath of boxing. Psychol Med 1973; 3 (3): 270–303. doi: 10.1017/s0033291700049588.

16. Handratta V, Hsu E, Vento J et al. Neuroimaging findings and brain-behavioral correlates in a former boxer with chronic traumatic brain injury. Neurocase 2010; 16 (2): 125–134. doi: 10.1080/13554790903329166.

17. Silk T, Beare R, Crossley L et al. Cavum septum pellucidum in pediatric traumatic brain injury. Psychiatry Res 2013; 213 (3): 186–192. doi: 10.1016/j.pscychresns.2013.03. 001.

18. Nopoulos P, Swayze V, Flaum M et al. Cavum septi pellucidi in normals and patients with schizophrenia as detected by magnetic resonance imaging. Biol Psychiatry 1997; 41 (11): 1102–1108. doi: 10.1016/S0006-3223 (96) 00 209-0.

19. Trzesniak C, Oliveira IR, Kempton MJ et al. Are cavum septum pellucidum abnormalities more common in schizophrenia spectrum disorders? A systematic review and meta-analysis. Schizophr Res 2011; 125 (1): 1–12. doi: 10.1016/j.schres.2010.09.016.

20. Chon MW, Choi JS, Kang DH et al. MRI study of the cavum septum pellucidum in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2010; 260 (4): 337–343. doi: 10.1007/s00406-009-0081-6.

21. Nopoulos P, Krie A, Andreasen NC. Enlarged cavum septi pellucidi in patients with schizophrenia: clinical and cognitive correlates. J Neuropsychiatry Clin Neurosci 2000; 12 (3): 344–349. doi: 10.1176/jnp.12.3. 344.

22. Flashman LA, Roth RM, Pixley HS et al. Cavum septum pellucidum in schizophrenia: clinical and neuropsychological correlates. Psychiatry Res 2007; 1554 (2): 147–155. doi: 10.1016/j.pscychresns.2006.09.001.

23. Dandy W. Congenital cerebral cysts of the cavum septi pellu-cidi (fifth ventricle) and cavum vergae (sixth ventricle). Arch NeurPsych 1931; 25 (1): 44–66. doi: 10.1001/archneurpsyc.1931.02230010056003.

24. Aoki N. Cyst of the septum pellucidum presenting as hemiparesis. Childs Nerv Syst 1986; 2 (6): 326–328. doi: 10.1007/bf00271950.

25. Gangemi M, Donati P, Maiuri F et al. Cyst of the velum interpositum treated by endoscopic fenestration. Surg Neurol 1997; 47 (2): 134–137. doi: 10.1016/s0090-3019 (96) 00367-9.

26. Wang KC, Fuh JL, Lirng JF et al. Headache profiles in patients with a dilatated cyst of the cavum septi pellucidi. Cephalagia 2004; 24 (10): 867–874. doi: 10.1111/j.1468-2982.2004.00760.x.

27. Sayama CM, Harnsberger HR, Couldwell WT. Spontaneous regression of a cystic cavum septum pellucidum. Acta Neurochir (Wien) 2006; 148 (11): 1209–1211. doi: 10.1007/s00701-006-0903-5.

28. Koçer N, Kantarci F, Mihmalli I et al. Spontaneous regression of a cyst of the cavum septi pellucidi. Neuroradiology 2000; 42 (5): 360–362. doi: 10.1007/s002340050899.

29. Liby P. Letter: the wolf sign. Neurosurgery 2017; 81 (5): E68–E69. doi: 10.1093/neuros/nyx460.

30. Kautzky R, Zülch KJ, Wende S et al. Neuroradiology. Berlin: Springer 1982.

31. Mapstone TB, White RJ. Cavum septi pellucidi as a cause of shunt dysfunction. Surg Neurol 1981; 16 (2): 96–98. doi: 10.1016/0090-3019 (81) 90104-X.

32. Yamada S, Goto T, Mccomb JG. Use of a spin-labeled cerebrospinal fluid magnetic resonance imaging technique to demonstrate successful endoscopic fenestration of an enlarging symptomatic cavum septi pellucidi. World Neurosurg 2013; 80 (3–4): 436.e15-8. doi: 10.1016/j.wneu.2012.01.039.

33. Amin BH. Symptomatic cyst of the septum pellucidum. Childs Nerv Syst 1986; 2 (6): 320–322. doi: 10.1007/bf00271948.

34. Wester K, Pedersen PH, Larsen JL et al. Dynamic aspects of expanding cava septi pellucidi et Vergae. Acta Neurochir (Wien) 1990; 104 (3–4): 147–150. doi: 10.1007/BF01842833.

35. Miyamori T, Miyamori K, Hasegawa T et al. Expanded cavum septi pellucidi and cavum vergae associated with behavioral symptoms relieved by a stereotactic procedure: case report. Surg Neurol 1995; 44 (5): 471–475. doi: 10.1016/0090-3019 (95) 00339-8.

36. Jackowski A, Kulshresta M, Sgouros S. Laser-assisted flexible endoscopic fenestration of giant cyst of the septum pellucidum. Br J Neurosurg 1995; 9 (4): 527–531. doi: 10.1080/02688699550041179.

37. Fratzoglou M, Grunert P, Leite dos Santos A et al. Symptomatic cysts of the cavum septi pellucidi and cavum vergae: the role of endoscopic neurosurgery in the treatment of four consecutive cases. Minim Invasive Neurosurg 2003; 46 (4): 243–249. doi: 10.1055/s-2003-42351.

38. Miki T, Wada J, Nakajima N et al. Operative indications and neuroendoscopic management of symptomatic cysts of the septum pellucidum. Childs Nerv Syst 2005; 21 (5): 372–381. doi: 10.1007/s00381-004-1063-7.

Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 2

2020 Issue 2

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account