Cavernoma of the Septum Pellucidum: Case Report and Review of Literature

Abstract

ABSTRACT Intraventricular cavernomas are rare and septum pellucidum cavernomas are still rarer with only nine reported cases in the literature. We present our experience with the successful surgical management of a patient with septum pellucidum cavernoma and discuss the management concerns. A 30-year-old male presented with raised intracranial pressure features of 1-month duration. Magnetic resonance imaging revealed obstructive hydrocephalus secondary to a lesion around the foramen of Monro mimicking a colloid cyst but with certain atypical imaging findings. First, a surgical attempt to excise the lesion was aborted due to vascularity and bleeding from the lesion. During the second surgery, a vascular mulberry-like lesion was seen attached to the septum pellucidum and complete excision was done in toto. Histopathological examination confirmed the diagnosis of cavernoma. The patient had an uneventful recovery and at 6-month follow-up is doing well except for minimal memory impairment related to forniceal injury. Septum pellucidum cavernomas can mimic a colloid cyst of the third ventricle on radiology and a differential diagnosis of cavernoma should be considered while attempting the excision of septal lesions. Complete excision is the treatment of choice and gives good results.