The septum pellucidum and its variants

An MRI study
  • Christine M. Born
  • Eva M. Meisenzahl
  • Thomas Frodl
  • Thomas Pfluger
  • Maximilian Reiser
  • H. J. Möller
  • Gerda L. Leinsinger
ORIGINAL PAPER

Abstract.

Purpose:

Increased prevalence of cavum septi pellucidi (CSP) in schizophrenic patients in comparison to healthy subjects was reported previously. Our purpose was to evaluate the prevalence of variants of the septum pellucidum in healthy subjects in three different age groups.

Methods:

151 healthy subjects, including 46 children (age 6 ± 4 years), 72 young adults (age 31 ± 8 years) and 33 elderly adults (age 59 ± 7 years) were examined with high-resolution MRI. Three observers analysed the images using a standardised protocol. We evaluated the incidences of CSP, cavum vergae (CV) and their length.

Results:

CSP was detected in 80% of the cases in the paediatric group and 68% of young adults and in 72% of the elderly adults. A cavum vergae (CV) was noted in 22% of the children, in 39% of the young adults and in 36% of the elderly subjects. There was no significant difference between the age-related groups.

Conclusion:

We detected a high prevalence of cavum septi pellucidi without a significant age dependence. Enlarged cava septi pellucidi are rare in healthy subjects.

Key words

cavum septi pellucidi cavum vergae septum pellucidum cysts MRI 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Scott TF, Price TP, George MS, Brillman J, Rothfus W (1993) Cerebral malformations and schizophrenia. J Neuropsychiatry Clin Neuroscience 5:287–293Google Scholar
  2. 2.
    Swayze VW II, Andreasen NC, Ehrhardt JC, Yuh WTC, Alliger RJ, Cohen G (1990) Developmental abnormalities of the corpus callosum in schizophrenia. Arch Neurol 47:805–808PubMedGoogle Scholar
  3. 3.
    Nopoulos PC, Flaum M, Andreasen NC, Swayze VW II (1995) Gray matter heterotopias in schizophrenia. Psychiatry Res 61:11–14PubMedGoogle Scholar
  4. 4.
    Degreef G, Bogerts B, Falkai P, Greve B, Lantos G, Ashtari M, Liebermann J (1991) Increased prevalence of the cavum septum pellucidum in magnetic resonance scans and post-mortem brains of schizophrenic patients. Psychiatry Res: Neuroimaging 45:1–13CrossRefGoogle Scholar
  5. 5.
    Degreef G, Lantos G, Bogerts B, Ashtari M, Liebermann J (1992) Abnormalities of the septum pellucidum on MR scans in first-period of schizophrenic patients. Am J Neuroradiol 13:835–840PubMedGoogle Scholar
  6. 6.
    De Lisi E, Hoff AL, Kushner M, Degreef G (1993) Increased prevalence of cavum septum pellucidum in schizophrenia. Psychiatry Res: Neuroimaging 1993:193–199CrossRefGoogle Scholar
  7. 7.
    Shiori T, Oshitani Y, Kato T, Murashita J, Hamakawa H, Inubushi T, Nagata T, Takahashi S (1996) Prevalence of cavum septum pellucidum detected by MRI in patients with bipolar disorder, major depression and schizophrenia. Psychol Med 26:431–434PubMedGoogle Scholar
  8. 8.
    Hagino H, Suzuki M, Kurokawa K,Mori K, Nohara S, Takahashi T, Yamashita I, Yotsutsuji T, Kurachi M, Seto H (2001) Magnetic Resonance Imaging Study of the Cavum Septi Pellucidi in Patients With Schizophrenia. Am J Psychiatry 158:1717–1719CrossRefPubMedGoogle Scholar
  9. 9.
    Filipovic B, Teofilovski-Parapid G (1998) Ageing changes of morphological characteristics of cavum septi pellucidi in adults: a dissectional study. Ital J Anat Embryol 103(2):107–116PubMedGoogle Scholar
  10. 10.
    Dandy WE (1932) Congenital cerebral cysts of the cavum septi pellucidi (fifth ventricle) and cavum vergae (sixth ventricle). Diagnosis and treatment. Arch Neurol Psychiatry 25:44–66Google Scholar
  11. 11.
    Schwidde TJ (1952) Incidence of cavum septi pellucidi and cavum vergae in 1032 human brains. Arch Neurol Psychiatry 67:625–632Google Scholar
  12. 12.
    O’Rahilly R, Müller F (1992) The Telencephalon. In: Human embryology and teratology. New York, Wiley-Liss. Inc, pp 272–277Google Scholar
  13. 13.
    Hochstetter F (1919) Beiträge zur Entwicklungsgeschichte des menschlichen Gehirns. Wien, Deutike 176Google Scholar
  14. 14.
    Rakic P, Yakovlev PI (1968) Development of the corpus callosum and cavum septi in man. J Comp Neurol 132:45–72PubMedGoogle Scholar
  15. 15.
    Pfluger T, Weil S, Vollmar C, Heiss D, Egger J, Scheck R, Hahn K (1999) Normative volumetric data of the developing hippocampus in children based on magnetic resonance imaging. Epilepsia 40:414–423PubMedGoogle Scholar
  16. 16.
    Nopoulos P, Krie A, Andreasen NC (2000) Enlarged cavum septi pellucidi in patients with schizophrenia: clinical and cognitive correlates. J Neuropsychiatry Clin Neurosci 12(3):344–349CrossRefPubMedGoogle Scholar
  17. 17.
    Andreasen N, Nasrallah HA, Dunn V, et al. (1986) Structural abnormalities in the frontal system in schizophrenia. Arch Gen Psychiatry 43:136–144PubMedGoogle Scholar
  18. 18.
    Bloom F (1993) Advancing a neurodevelopmental origin for schizophrenia. Arch Gen Psychiatry 50:224–227PubMedGoogle Scholar
  19. 19.
    De Lisi LE, Liebermann J (1993) Longitudinal perspectives on the pathophysiology of schizophrenia: Examining the neurodevelopmental versus neurodegenerative hypotheses. Psychiatry Res Neuroimaging 139:147–150Google Scholar
  20. 20.
    Murray RB, O’Callaghan E, Castle DJ, Lewis SW (1992) A neurodevelopmental approach to the classification of schizophrenia. Schizophr Bull 182:319–332Google Scholar
  21. 21.
    Bigelow LB, Nasrallah HA, Rauscher FP (1983) Corpus callosum thickness in chronic schizophrenia. Br J Psychiatry 142:284–287PubMedGoogle Scholar
  22. 22.
    Nopoulos P, Swayze V, Andreasen NC (1996) Pattern of brain morphology in patients with schizophrenia and large cavum septi pellucidum. J Neuropsychiatry Clin Neurosci 8:147–152PubMedGoogle Scholar
  23. 23.
    Andreasen NC, Smith MR, Jacoby CG, Dennert JW, Olsen SA (1982) Ventricular enlargement in schizophrenia. Definition and prevalence. Am J Psychiatry 139:292–296PubMedGoogle Scholar
  24. 24.
    Weinberger DR, Bigelow LB, Kleinman JE, Klein ST, Rosenblatt JE, Wyatt RJ (1980) Cerebral ventricular enlargement in chronic schizophrenia: An association with poor response to treatment. Arch Gen Psychiatry 37:11–13PubMedGoogle Scholar
  25. 25.
    Rauschning W (1994) Brain tumours and tumour-like masses: classification and differential diagnosis. In: Osborn AG (ed) Diagnostic neuroradiology. Mosby Yearbook, pp 422–426Google Scholar
  26. 26.
    Bodensteiner JB (1995) The saga of the septum pellucidum: a tale of unfounded clinical investigations. L Child Neurol 10:227–231Google Scholar
  27. 27.
    Spillane JD (1962) Five boxers. BMJ ii:1205–1210Google Scholar
  28. 28.
    Corsellis JAN (1989) Boxing and the brain. BMJ 298:105–109PubMedGoogle Scholar
  29. 29.
    Moseley IF (2000) The neuroimaging evidence for chronic brain damage due to boxing. Neuroradiology 42:1–8CrossRefPubMedGoogle Scholar
  30. 30.
    Shaw CM, Alvord EC (1969) Cavum septi pellucidi et vergae: Their normal and pathological states. Brain 92:213–224PubMedGoogle Scholar
  31. 31.
    Nakano S, Hojo H, Kataoka K, Ramasak S (1981) Age related incidence of cavum septi pellucidi and cavum vergae on CT scans of paediatric patients. J Comput Assist Tomogr 5:348–349PubMedGoogle Scholar
  32. 32.
    Sarwar M (1989) The septum pellucidum: Normal and abnormal. Am J Neuroradiol 989–1005Google Scholar
  33. 33.
    Schaefer GB, Bodensteiner JB, Thompson JN (1994) Subtle anomalies of the septum pellucidum and neurodevelopmental deficits. Dev Med Child Neurol 36:554–559PubMedGoogle Scholar
  34. 34.
    Renier D, Arnaud E, Cinalli G, Sebag G, Zerah M, Marchac D (1996) Prognosis of mental function in Apert’s syndrome. J Neurosurg 85:66–72PubMedGoogle Scholar
  35. 35.
    Barkovich AJ, Fram EK,Norman D (1989) Septo-optic dysplasia: MR imaging. Radiology 171:189–192PubMedGoogle Scholar
  36. 36.
    Barkovich AJ, Norman D (1989) Absence of the septum pellucidum: a useful sign in the diagnosis of congenital brain malformations. Am J Roentgenol 152:353–360Google Scholar
  37. 37.
    Supprian T, Heils A, Hofmann E, Warmuth-Metz M, Solymosi L (1999) Isolated absence of the septum pellucidum. Neuroradiology 41:563–566CrossRefPubMedGoogle Scholar
  38. 38.
    Jurjus GJ, Nasrallah HA, Olsen SC, Schwarzkopf SB (1993) Cavum septum pellucidum in schizophrenia, affective disorders and healthy controls. A magnetic resonance imaging study. Psychol Med 23:319–322PubMedGoogle Scholar
  39. 39.
    Nopoulos P, Swayze V, Flaum M, Ehrhardt JC, Yuh WTC, Andreasen NC (1997) Cavum septi pellucidi in normals and patients with schizophrenia as detected by magnetic resonance imaging. Biol Psychiatry 41:1102–1108CrossRefPubMedGoogle Scholar
  40. 40.
    Van Wagenen WP, Aird RB (1934) Dilatations of the cavity of the septum pellucidum and cavum vergae. Am J Cancer 23:539–557Google Scholar
  41. 41.
    Hughes RA, Kemohan JW, Winchell MK (1955) Caves and cysts of the septum pellucidum. Arch Neurol Psychiatry 74:259–266Google Scholar
  42. 42.
    Shunk H (1963) Congenital dilatations of the septum pellucidum. Radiology 81:610–618Google Scholar
  43. 43.
    Nopoulos PC, Jay N, Andreasen NC, Rapaport JL (1998) Frequency and severity of enlarged cavum septi pellucidi in childhood-onset schizophrenia. Am J Psychiatry 155:1074–1079PubMedGoogle Scholar
  44. 44.
    Lewis SW, Mezey GC (1985) Clinical correlates of septum pellucidum cavities: An unusual association with psychosis. Psychol Med 15:43–54PubMedGoogle Scholar
  45. 45.
    Schwidde JT (1952) Incidence of cavum septi pellucidi et vergae in 1,032 human brains. Arch Neurol Psychiatry 67:625–633Google Scholar
  46. 46.
    Swayze VW II, Andreasen NC, Alliger RJ, Ehrhardt JC, Yuh WT (1990) Structural brain abnormalities in bipolar affective disorder. Ventricular enlargement and focal signal hyperintensities. Arch Gen Psychiatry 47:1054–1059PubMedGoogle Scholar
  47. 47.
    Bogerts B, Ashtari M, Degreef G, Alvi RJ, Bilder R, Liebermann J (1990) Reduced temporal limbic structure volumes on magnetic resonance imaging in first episode schizophrenia. Psychiatry Res Neuroimaging 35:1–13CrossRefGoogle Scholar
  48. 48.
    Suddath RL, Casanova MF, Goldberg TE, Daniel DG, Kelsoe JR, Weinberger DR (1989) Temporal lobe pathology in schizophrenia. A quantitative magnetic resonance imaging study. Am J Psychiatry 146:464–472PubMedGoogle Scholar
  49. 49.
    Larroche JC, Baudey J (1962) Cavum septi pellucidi, cavum vergae, cavum veli interpositi: Cavities de la ligne mediane. Etude anatomique et pneumoencephalographique dans la période neonatale. Biologia Neonate 3:193–236Google Scholar
  50. 50.
    Kocer N, Kantarci E, Mihmalh I, Islak C, Cokyüksel O (2000) Spontaneous regression of a cyst of the cavum septi pellucidi. Neuroradiology 42:360–362CrossRefPubMedGoogle Scholar
  51. 51.
    Bruyn GW (1997) Agenesis septi pellucidi,cavum septi pellucidi, cavum vergae and cavum veli interpositi. In: Vinken Pf, Bruyn GW (eds) Handbook of clinical neurology, Vol. 30, Amsterdam, Elsevier pp 299–336Google Scholar
  52. 52.
    Nakano S, Hojo H, Kataoka K,Yamasaki S (1981) Age related incidence of cavum septi pellicidi and cavum vergae on CT scans of pedriatic patients. Comput Assist Tomogr 5:348–349PubMedGoogle Scholar
  53. 53.
    Aldur MM, Gurcan F, Basar R, Aksit MD (1999) Frequency of septum pellucidum anomalies in non-psychotic population: a magnetic resonance imaging study. Surg Radiol Anat 21(2):119–123PubMedGoogle Scholar
  54. 54.
    Oterruelo FT (1986) On the cavum septi pellucidi and the cavum vergae. Anat Anz 162(4):271–278PubMedGoogle Scholar
  55. 55.
    Auer RN, Gilbert JJ (1982) Cavum vergae without cavum septi pellucidi. Arch Pathol Lab Med 106(9):462–463PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  • Christine M. Born
    • 1
  • Eva M. Meisenzahl
    • 2
  • Thomas Frodl
    • 2
  • Thomas Pfluger
    • 3
  • Maximilian Reiser
    • 1
  • H. J. Möller
    • 1
  • Gerda L. Leinsinger
    • 1
  1. 1.Institute for Clinical RadiologyUniversity MunichMunichGermany
  2. 2.Dept. of PsychiatryUniversity MunichMunichGermany
  3. 3.Dept. of Nuclear MedicineUniversity MunichMunichGermany

Personalised recommendations