Linking Type and Extent of Head Trauma to Cavum Septum Pellucidum in Older Adults With and Without Alzheimer Disease and Related Dementias.

BACKGROUND AND OBJECTIVES: Cavum septum pellucidum (CSP) is a common but nonspecific MRI finding in individuals with prior head trauma. The type and extent of head trauma related to CSP, CSP features specific to head trauma, and the impact of brain atrophy on CSP are unknown. We evaluated CSP cross-sectionally and longitudinally in healthy and clinically impaired older adults who underwent detailed lifetime head trauma characterization. METHODS: This is an observational cohort study of University of California, San Francisco Memory and Aging Center participants (healthy controls [HCs], those with Alzheimer disease or related dementias [ADRDs], subset with traumatic encephalopathy syndrome [TES]). We characterized traumatic brain injury (TBI) and repetitive head impacts (RHI) through contact/collision sports. Study groups were no RHI/TBI, prior TBI only, prior RHI only, and prior RHI + TBI. We additionally looked within TBI (1, 2, or 3+) and RHI (1-4, 5-10, and 11+ years). All underwent baseline MRI, and 67% completed a second MRI (median follow-up = 5.4 years). CSP measures included grade (0-4) and length (millimeters). Groups were compared on likelihood of CSP (logistic regression, odds ratios [ORs]) and whether CSP length discriminated groups (area under the curve [AUC]). RESULTS: Our sample included 266 participants (N = 160 HCs, N = 106 with ADRD or TES; age 66.8 ± 8.2 years, 45.3% female). Overall, 123 (49.8%) participants had no RHI/TBI, 52 (21.1%) had TBI only, 41 (16.6%) had RHI only, 31 (12.6%) had RHI + TBI, and 20 were classified as those with TES (7.5%). Compared with no RHI/TBI, RHI + TBI (OR 3.11 [1.23-7.88]) and TES (OR 11.6 [2.46-54.8]) had greater odds of CSP. Approximately 5-10 years (OR 2.96 [1.13-7.77]) and 11+ years of RHI (OR 3.14 [1.06-9.31]) had higher odds of CSP. CSP length modestly discriminated participants with 5-10 years (AUC 0.63 [0.51-0.75]) and 11+ years of prior RHI (AUC 0.69 [0.55-0.84]) from no RHI/TBI (cut point = 6 mm). Strongest effects were noted in analyses of American football participation. Longitudinally, CSP grade was unchanged in 165 (91.7%), and length was unchanged in 171 (95.5%) participants. DISCUSSION: Among older adults with and without neurodegenerative disease, risk of CSP is driven more by duration (years) of RHI, especially American football, than number of TBI. CSP length (≥6 mm) is relatively specific to individuals who have had substantial prior RHI. Neurodegenerative disease and progressive atrophy do not clearly influence development or worsening of CSP.

Cavum septum pellucidum gigante y deterioro cognitivo en la esquizofrenia: análisis de un caso clínico / Giant cavum septum pellucidum and cognitive impairment in schizophrenia: analysis of a clinical case

El cavum septum pellucidum (CSP) es una alteración morfológica del septum pellucidum que debe desaparecer entre los tres y los seis meses de vida. Los CSP que persisten después de esa fecha y los de tipo no comunicante se consideran una alteración del neurodesarrollo y se han relacionado con la esquizofrenia y otros trastornos psicóticos, especialmente los de gran tamaño. La prevalencia es variable en función del método de medida, de modo que encontramos cifras que oscilan entre el 0,1% a 85% en la población general y entre el 15 a 44,8% en la esquizofrenia. En los pacientes con trastornos psicóticos y CSP grandes se han observado una serie de características clínicas tales como, mayor presencia de síntomas negativos, alteraciones cognitivas del aprendizaje verbal y de la comprensión de frases, entre otras. Presentamos el caso clínico de una paciente de 19 años diagnosticada de esquizofrenia hebefrénica en la que se halló mediante tomografía computerizada (TC) un CSP de tamaño gigante (2,6 cm) y en la que destaca la importante presencia de síntomas negativos, el deterioro cognitivo, las alteraciones del aprendizaje verbal y de la comprensión de frases e importantes trastornos de conducta (AU)

Cavum septum pellucidum (CSP) is a morphological alteration of the septum pellucidum that should disappear at 3-6 months of age. CSPs that persist for longer, and non-communicating CSP, are classified as a neurodevelopmental disorders and have been associated with schizophrenia and other psychotic disorders, especially in cases with large CSPs. Prevalence rates vary according to the measurement method, and the figures range from 0,1% to 85% in the general population and from 15% to 44,8% in schizophrenia. A series of clinical features such as cognitive disorders, more negative symptoms and verbal learning and sentence comprehension disorders has been found in patients with psychotic disorders and large CSP. We present the clinical case of a 19-year old patient diagnosed with hebephrenic schizophrenia in which a CT scan revealed a giant CSP (2,6 cm) and who presented significant negative symptoms, cognitive deterioration, verbal learning and sentence comprehension disorders and important behavioural disorders (AU)

Subependimoma del septum pellucidum. Un caso poco frecuente de tumor cerebral causante de hidrocefalia / Subependymoma of septum pellucidum. An unusual case of a brain tumor causing hydrocephaly

Presentamos en nuestro trabajo un caso de subependimoma cerebral, observado en una mujer de 42 años, aquejada de un cuadro de hidrocefalia obstructiva. El tumor localizado en el septum pellucidum provocaba obstrucción del agujero de Monro. Tras su extirpación total, el estudio histológico de la pieza reveló una neoplasia de arquitectura nodular, con presencia de quistes y pequeños grupos celulares dentro de una trama fibrilar, halallazgos típicos del subependimoma(AU)

We present a case of a subependymoma in a 42-year-old woman presenting with obstructive hydrocephaly. The tumour was located in the septum pellucidum obstructing Monro's foramen. Following total surgical removal, the neoplasm was seen to have a nodular architecture with microcysts and clusters of cells in a fibrillary background, all features typical of subependymoma(AU)

Acesso endoscópico transepto-interforniceal para cistos colóides: relato de caso / Endoscopic transepto-interforniceal approach to colloid cysts: case report

A abordagem endoscópica de cistos colóides ainda é matéria controversa. As opçoes de tratamento sao variadas: observaçao com exames seriados, tratamento da hidrocefalia, aspiraçao por estereotaxia, microcirurgia e endoscopia. O autor relata o caso de um paciente com cisto colóide do terceiro ventrículo, localizado em posiçao retroforaminal, no teto diencefálico, dissecando os dois fornices projetando-se supero-posteriormente em direçao ao assoalho do ventrículo lateral, por dentro do cavum do septo pelúcido. A lesao foi alcançada com neuroendoscópio rígido, através de um orifício de trépano pré-coronal situado a 2,5 cm da linha média (ponto de Kocher). Seguindo por via transventricular, a lâmina direita do septo pelúcido foi aberta, posterior à veia septal. A lesao, muito endurecida, situada entre os dois fórnices, foi parcialmente ressecada através da via endoscópica transventricular transepto-interforniceal. Realizamos também septostomia e terceiro ventriculostomia endoscópicas neste paciente. Os diferentes tipos de procedimentos cirúrgicos das patologias situadas no terceiro ventrículo sao discutidos com ênfase no papel da endoscopia

Septo-optic dysplasia: case report

The clinical triad of septo-optic dysplasia (SOD) comprises the abscence of the septum pellucidum, congenital optic nerve dysplasia, and multiple endocrine disorders. When any two of these factors are present, the condition is defined as an imcomplete form of SOD. The authors report the case of an imcomplete form of SOD in a 9-year old boy with low vision and nystagmus present from birth. The bilateral ophthalmoscopic examination revealed small papillae with double countour images. Magnetic resonance imaging showed hypoplasia of the optic nerve bilaterally, chiasm and absence of the septum pellucidum.

Cavum septum pellucidum en la esquizofrenia: a propósito de un caso / Cavum septum pellucidum in schizophrenia: a case report

En los pacientes con esquizofrenia están descritas en mayor proporción que en la población general diversas alteraciones estructurales del sistema nervioso central, como el aumento del tamaño de los ventrículos, la disminución del volumen del hipocampo y la amígdala y otras alteraciones que traducen probablemente una pérdida de volumen neuronal y del neuropilo (arborizaciones axonales y dendríticas) vinculado a una alteración precoz del neurodesarrollo. Entre las alteraciones cuyo rol en la enfermedad es más desconocido se encuentra el cavum septum pellucidum. Ésta es una anomalía frecuente, pero poco conocida, ya que en pocos casos llama la atención la cavidad entre las dos láminas del septo. Según diversos estudios esta alteración es más frecuente en pacientes con esquizofrenia que en sujetos sanos y en la actualidad se está estudiando su asociación a la enfermedad. A continuación presentamos el caso de una paciente de 37 años, sin antecedentes destacables, que ingresó en nuestro servicio de psiquiatría por presentar sintomatología psicótica

Different structural alterations of the central nervous syste (CNS), such as an increase in ventricular size, decrease in hippocampus and amygdala volume, and other abnormalities that are probably secondary to a loss of neuronal mass and neuropili (axons and dendrite ramifications) linked to a precocious alteration in neurodevelopment are described in patients with schizophrenia in greater proportion than in the general population. The Cavum septum pellucidum is among the alterations whose role in the disease is more unknown, since the cavity between the two septum laminae draws attention in very few cases. According to several studies, this alteration is more frequent in patients with schizophrenia than in healthy subjects and currently its association to the disease is being studied. In the following, we present the case of a 37 year old patient with no outstanding background, who was admitted to our psychiatry department due to psychotic symptoms

Dilatación del cavum Vergae en el feto: dos casos clínicos y revisión de la literatura / Dilated cavum Vergae in the fetus: two clinical cases and literature review

Comunicamos el diagnóstico prenatal de dos casos de dilatación del cavum Vergae. También revisamos la literatura acerca de lesiones anecogénicas intracerebrales supratentoriales interhemisféricas, con el propósito de establecer criterios de diagnóstico diferencial antenatal y determinar su pronóstico.

Displasia Septo-optica (Síndrome de Morsier): A propósito de un caso / Septo-optic dysplasia (Morsier's syndrome): Apropos of a case

Lactante menor, sexo femenino, con asociación de anomalías congénitas que incluyeron hipoplasia bilateral del nervio óptico, agenesia del septum pellucidum y diábetes insípida central, entre otras manifestaciones menores. La agenesia del septum pellucidum demostrada por resonancia magnética cerebral, así como la hipoplasia del nervio óptico por fondo de ojo. Manifestaciones renales, en particular las derivadas de la diábetes insípida respondieron con la Lisina-Vasopresina, desapareciendo el cuadro de emenis persistente y acidosis sistémica. La valoración pediátrica evidenció un retraso psicomotor y déficit pondoestatural significativos. Paciente cumple en la actualidad con sus controles especializados