The prevalence of cavum septum pellucidum in brain imaging of mental health referrals in a South African population

Jacobs, Kathleen Louise
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INTRODUCTION: The cerebral anomaly of a cavum septum pellucidum (CSP) has been the subject of controversy in neuroimaging since the hallmark study by DeGreef in 1992. The association of CSP with schizophrenia and postulation of CSP as a marker of cerebral midline maldevelopment has been studied extensively with no consistent outcome. The storm of debate underlies the requirement for a reliable objective imaging marker as an organic cause of mental illness. AIM: This study aims to determine the prevalence of cavum septum pellucidum in mental health referrals in South Africa and determine the significance thereof. METHOD: This was a retrospective, observational study based at Baragwanath Hospital, including 114 mental health referrals and 114 controls, matched for age and sex. The CT scans of these patients’ brains were anonymously reviewed by three independent radiologists/radiologists in training to determine the prevalence of CSP, and the length and width of CSP’s, if present. RESULTS: There was no statistical significance in the difference in prevalence of CSP between the mental health referrals and controls. The anteroposterior length of CSP was not a statistically significant determinant of mental illness but an increased average axial width was a statistically significant measurement in the mental health referrals. CONCLUSIONS: The axial width of CSP is a statistically significant determinant of mental illness.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology. Johannesburg, 2015