Surgical experiences of expanded symptomatic cavum septi pellucidi: Report of two cases

We report 2 cases of surgically treated headache caused by the expanded cavum septi pellucidi (CSP). The first case was a 44-year-old female and the second one a 23-year-old male, both presenting with obstinate headache resistant to medical treatment. Width of expanded cavum septi pellucidi, namely the septal cyst, was 18 mm and 17 mm in diameter, respectively. There were no signs of hydrocephalus but cavum vergae was associated in the first case. CT cisternography demonstrated no direct communication between the cyst and the cerebrospinal fluid space, but revealed slight accumulation and stasis of the contrast medium in the cyst after 6 and 24 hours. Stereotactic direct puncture of the cyst was done from the right frontal cortex through the corpus callosum. The cyst was drained into the frontal subdural space, using a catheter (internal cyst-subdural drainage). Headache disappeared immediately after surgery in both cases and the width of the cyst decreased 9 mm and 8 mm, respectively.