A 58-Year Old Male with Cognitive Deteriorations Caused by Septum Pellucidum Cyst: A Case Report

Abstract

Dementia is known to be induced by vascular dementia and certain neurodegenerative diseases. The presenting features of disordered memory, intellect and personality often result in referral to a neurologist initially. Septum pellucidum cyst (SPC) is a rare clinical finding and defined as a cystic structure between the lateral ventricles. SPC induced memory disorder and dementia has been seldom reported in which the clinical features are atypical and can be misdiagnosed. The main difficulty is to establish a correlation between symptoms and the cyst. When indicated, the treatment is essentially surgical and the ideal operative technique is also a matter of debate. Here, we reported a 58-year-male Chinese patient who presented with memory impairment 1 year ago. Both the physical and laboratory examinations were performed to evaluate the general conditions of the patient. Brain magnetic resonance imaging (MRI) was applied to observe SPC and the neighboring brain structures. Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The results of the patient’s laboratory examinations were normal. However, the patient exhibited severe sleeplessness along with cognitive deteriorations despite short-term (less than 2 weeks) use of benzodiazepines with regular dose. MRI fulfills the consensus criteria for clinical diagnosis of SPC. Furthermore, the results of MMSE and MoCA were showed mild cognitive impairment (MCI) before the treatment of SPC. After neuroendoscopic fenestration of SPC, the patient’s syndromes were disappeared, and his cognitive function was improved. In conclusion, the patient’s symptoms were due to a secondary lesion attributed to the cyst. Comprehensive clinical evaluation and MRI help diagnose SPC induced dementia.

Characteristic and Management of Symptomatic Septum Pellucidum Cyst in Extreme Elderly Patient: Case Report and Literature Review

“…The reported elderly cases of symptomatic SPCs, including the case described here, are shown in Table 1. 6,[12][13][14] Majority of the patients aged above 50 years complained of gait disturbance (about 67%). On the other hand, the reported cases, except the case presented here, complained of headache that might be related to high intracranial pressure.…”

Basal Forebrain Impairment: Understanding the Mnemonic Function of the Septal Region Translates in Therapeutic Advances

“…The authors concluded that disconnection of the pathway between the diagonal band of Broca and the hippocampus contributed to declarative memory impairment ( Abe et al, 1998 ). A patient with a rare septum pellucidum cyst presented with memory impairment, an MRI scan showed that the cyst was limited to the septal region ( Chen et al, 2017 ). Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) revealed mild cognitive impairment before the treatment of the cyst.…”

“…After neuroendoscopic fenestration of the cyst, the patient’s memory has improved. The authors concluded that the patient’s episodic memory disorder was due to a secondary septal lesion attributed to the cyst ( Chen et al, 2017 ). Studies in healthy participants extended the focus of septal contribution to memory formation.…”