Operative indications and neuroendoscopic management of symptomatic cysts of the septum pellucidum

Objective: Since there is no current consensus on the diagnostic standards or surgical indications for symptomatic cysts of the septum pellucidum (CSP), we presented our experience treating such cases with neuroendoscopic surgery in order to possibly make a contribution to the attainment of such a consensus. Methods: In the last 5 years, we effectively treated 5 patients (4 males and 1 female) with CSP by neuroendoscopic surgery. The 3 congenital cases were young: 9, 14, and 29 years old. The 2 secondary cases were adults aged 51 and 65 years old. We were able to fenestrate, and biopsy for pathological analysis, the cyst walls of symptomatic CSP using a minimally invasive neuroendoscopic technique, with postoperative improvement in compression of adjacent structures, as well as clinical signs. Conclusions: It is necessary to consider the overall picture including clinical signs, progress of the condition, intracranial pressure, and cerebral circulation, in deciding whether surgery is indicated. Neuroendoscopic surgery is an effective, optimal, and convenient therapeutic modality for symptomatic CSP.