Cavum veli interpositi: just an anatomical variant or a potentially symptomatic CSF compartmentalization?

Pediatric Neurosurgery
Carlo GiussaniErik P Sganzerla

Abstract

The cavum veli interpositi (CVI) usually is a small CSF-containing abnormality of septum pellucidum, asymptomatic and rare after the age of 3 years. When symptomatic, it is large and can be related to psychiatric disorders, syndromic association of mental retardation and seizures or to hydrocephalus. This is the first reported case of an otherwise healthy pediatric patient with a large CVI experiencing episodes of hypertonic loss of consciousness unrelated to epileptic, cardiologic or psychiatric causes without signs of chronic increase in intracranial pressure (ICP). Supposing a CSF compartmentalization in the CVI as the cause of acute poussés of ICP due to block of CSF pathways and considering the severity of the symptoms, an endoscopic fenestration was performed with a reduction of cyst dimensions. We suggest considering the fenestration of large CVI even in otherwise asymptomatic patients to avoid the risk of CSF compartmentalization with ICP poussés.

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Citations

Nov 1, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Bettina KnieHideki Ogiwara
Jul 19, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Phillip CopleyKristian Aquilina
Apr 30, 2020·Operative Neurosurgery·Alexandre SimoninChristopher Lind
Nov 3, 2017·Surgical and Radiologic Anatomy : SRA·Satoshi TsutsumiYukimasa Yasumoto
Dec 20, 2020·Neurosurgical Review·Alexandre Simonin, Christopher R P Lind

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