Correctly identifying its presence or absence is very important in predicting the course of fetal central forebrain development. Visualisation of the CSP has become an essential component of a second and third trimester prenatal ultrasound. The cavum septi pellucidi (CSP) is an important landmark in the evaluation of the fetal neural axis, identified as a fluid-filled space between the leaves of the septum pellucidum. Examination of the fetal brain by MRI can confirm the sonographic findings and evaluate for associated anomalies.Non-visualisation of the CSP is most commonly associated with other neuroanatomical abnormalities.Cavum septi pellucidi (CSP) is an important landmark in the prenatal ultrasound evaluation of the fetal brain, and is a marker for normal central forebrain development.Visualisation of the CSP is an integral component of the prenatal ultrasound and its non-visualisation is associated with other malformations, diagnosis of which is aided by MRI. When non-visualisation of the CSP is suspected, magnetic resonance imaging (MRI) of the fetal brain can confirm and evaluate associated anomalies. Common pitfalls in the sonographic evaluation of CSP include columns of the fornix that mimic CSP, and prominent cavum vergae that can simulate non-visualisation of the CSP. Isolated septal deficiency, a rare but controversial entity, is considered a variant of normal. Non-visualisation of the CSP is a prenatal sonographic finding, which in most cases is associated with neuroanatomical anomalies that include agenesis of the corpus callosum, schizencephaly, septo-optic dysplasia, holoprosencephaly, chronic hydrocephalus and acquired fetal brain injury. Observation of a normal cavum septi pellucidi (CSP) is an important landmark in the second and third trimester prenatal ultrasound evaluation of the fetal brain, and its visualisation provides reassurance of normal central forebrain development. This manuscript reviews congenital anomalies and imaging findings associated with non-visualisation of the cavum septi pellucidi (CSP) found on prenatal sonogram.
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