Cavum velum interpositum

Case contributed by Dr Matt A. Morgan

Presentation

Stage IV pancreatic adenocarcinoma. Recent ataxia and poor co-ordination. General worsening of performance status. Rule out brain metastases.

Patient Data

Age: 80-85 years
Gender: Male
MRI

Prominent cavum velum interpositum.

Diffuse age-related cerebral volume loss.

No intracranial hemorrhage, acute ischemia, extra-axial collection, mass effect, or midline shift. There are a few foci of T2 hyperintensity in the white matter, which are nonspecific. No intracranial metastasis.

Case Discussion

The cavum velum interpositum is a normal variant in which there is a dilated CSF space involving the velum interpositum. When larger than 1 cm in axial transverse measurement, with outwardly bowed margins and positive mass effect, then term cyst of the velum interpositum may be used.

It is most often seen as an enlarged CSF space situated behind the foramen of Monro, beneath the columns of the fornices and above the tela choroidea of the 3rd ventricle. 

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