Cavum Septum Pellucidum Causing Obstructive Hydrocephalus in a Toddler

Area of Science:

• Neuroscience
• Developmental Biology
• Pediatric Neurology

Background:

• Cavum septi pellucidi (CSP) are common midline brain cysts, usually asymptomatic.
• Increased incidence of CSP is noted with head trauma and certain neurological and psychiatric conditions.
• Normally, CSP do not impede cerebrospinal fluid (CSF) flow.

Observation:

• A toddler presented with headaches and vomiting, exacerbated by physical activity.
• Neurological examination revealed no abnormalities.
• Brain MRI showed a large CSP causing obstructive hydrocephalus.

Findings:

• Endoscopic fenestration of the large CSP successfully resolved the obstructive hydrocephalus.
• The patient's symptoms, including headaches and vomiting, completely resolved post-procedure.
• Cerebrospinal fluid (CSF) flow studies can aid in diagnosing CSP-induced hydrocephalus.

Implications:

• While generally asymptomatic, large CSP can rarely lead to critical conditions like obstructive hydrocephalus.
• This case highlights the importance of considering CSP in pediatric patients with unexplained symptoms suggestive of increased intracranial pressure.
• Prompt diagnosis and surgical intervention, such as endoscopic fenestration, can lead to excellent outcomes in symptomatic CSP cases.