Affiliations: Department of Cell Biology, University of Alabama at
Birmingham, Alabama, U.S.A. | Department of Pediatric Neurosurgery, Children's
Hospital, Birmingham, Alabama, U.S.A.
Abstract: Midline cysts of the anterior brain are common in infants e.g. cavum
septum pellucidum et vergae. We report twin brothers with midline intracranial
cysts, mildly increased ventricular size, and macrocephaly. One brother had a
cavum septum pellucidum and vergae and the other a cavum septum pellucidum.
With the obliteration of each brother's midline cyst the head circumference was
noted to return to a normal head circumference curve and the ventricles
decreased in size. We hypothesize that in infancy some cases of infantile
macrocephaly are induced by a midline cyst and that as the cyst obliterates
that physiologic cerebrospinal fluid pathways are established so that the head
circumference returns within normal parameters. This knowledge should be kept
in mind by the clinician who may wish to surgically intervene with a midline
cyst prior to it demonstrating its natural history. Moreover, these data should
especially be entertained in the premature infant. (J Pediatr Neurol 2004;
2(2): 107–110).