A cavum vergae (CV) is a potential space in the brain, located on the midline behind a similar space called the cavum septum pellucidum. The presence of a CV is considered a normal anatomical variant and not a sign of disease. For most individuals, it is a harmless remnant from fetal development that does not cause symptoms or require medical intervention.
Anatomical Location and Development
The cavum vergae is found posterior to an arbitrary line formed by the columns of the fornix, a C-shaped bundle of nerve fibers. The CV is a posterior extension of the cavum septi pellucidi (CSP), a space between two thin membranes that separate the brain’s lateral ventricles. If both are present, they form a continuous channel along the midline of the brain.
These cavities are a normal part of fetal brain development. The septum pellucidum, which separates the two lateral ventricles, develops as two distinct membranes. The space between these membranes is the CSP, and its extension backward is the CV. During late fetal development and after birth, these membranes fuse, causing the cavities to close.
This fusion process occurs from back to front. The cavum vergae is expected to close within six months after birth, followed by the closure of the cavum septi pellucidi. The persistence of these spaces into adulthood defines them as anatomical variants. They are not part of the brain’s ventricular system because they have a different origin and are not lined with the cells that produce cerebrospinal fluid.
Prevalence and Clinical Significance
The presence of a cavum vergae is more common in newborns than in the adult population. While most premature and many full-term newborns have these midline cavities, the prevalence decreases significantly with age as the structures fuse. In adults, the rate is considerably lower; one study of over 19,000 brain scans found a combined prevalence for CSP and CV of less than 1%.
For the vast majority of people, a cavum vergae produces no symptoms and has no clinical significance. The presence of this anatomical variation does not affect a person’s intelligence or normal day-to-day brain function. It does not disrupt the function of surrounding brain structures and is not associated with neurological deficits.
Its discovery rarely warrants medical intervention or follow-up imaging. The primary clinical relevance is to recognize it as a normal variant. This recognition helps to avoid unnecessary further investigation or patient anxiety.
Association with Neurological and Psychiatric Conditions
While most often a benign finding, some research has explored a statistical correlation between persistent midline cavities and certain neurodevelopmental or psychiatric conditions. Studies have noted a higher prevalence of these anatomical variants in individuals with conditions such as schizophrenia, mood disorders, and post-traumatic stress disorder. A statistical association does not imply causation, and the presence of a CV does not mean an individual will develop such a condition.
These findings have led researchers to hypothesize that a persistent cavum vergae might be a non-specific marker of an altered neurodevelopmental trajectory. The theory suggests that factors that contribute to a psychiatric condition might also influence the fusion of the septal leaflets after birth. The CV itself is not believed to cause the conditions.
The cavum vergae is viewed by some as an indicator that brain development may have deviated from its path. However, it is just one of many biological markers being investigated and holds little predictive value on its own. The majority of individuals with a cavum vergae have no associated neurological or psychiatric illness.
Diagnosis and Management
A cavum vergae is identified incidentally during brain imaging procedures. It may be seen on a computed tomography (CT) scan or, more clearly, on a magnetic resonance imaging (MRI) scan of the brain. These scans are ordered for reasons unrelated to the CV, such as evaluating a head injury or investigating chronic headaches.
Because a cavum vergae is a normal anatomical variant, no specific treatment is necessary. The standard medical approach is one of reassurance and education. A physician will explain that it is a common and harmless finding that does not require any follow-up imaging or intervention.
In rare instances, a very large cavum vergae can become cystic, expanding and putting pressure on adjacent brain structures, which could cause symptoms. This is a significant exception and not a typical presentation. In such unusual cases, a neurosurgical consultation might be considered to relieve pressure.