Isolated traumatic hemorrhage of the septum pellucidum without neurological deficits: A radiological case report

The reported etiologies of hemorrhage of the septum pellucidum, represent a rare condition that mostly presents with neurological manifestations and poses a diagnostic challenge, which include trauma, vascular malformations, and tumors. Recognition of asymptomatic cases is important to avoid misdiagnosis and unnecessary intervention. A 69-year-old man fell from approximately 2 meters, sustaining a frontal head impact resulting in a large subcutaneous hematoma. Remarkably, he remained completely asymptomatic. Computed tomography revealed an isolated ovoid hemorrhage (1.5 × 2 cm) confined to the septum pellucidum. Previous imaging revealed no pre-existing lesions in this region. Magnetic resonance imaging demonstrated no vascular malformation, tumor, or other traumatic lesions. The follow-up magnetic resonance imaging performed at 3 months confirmed complete spontaneous resolution, with the patient's neurological function remaining intact. This case demonstrates that moderate head trauma can result in isolated septum pellucidum hemorrhage through localized vascular shear injury without classical diffuse axonal injury. Recognition of this rare, asymptomatic presentation underscores the importance of thorough magnetic resonance imaging evaluation and longitudinal follow-up in atypical intraventricular hemorrhage. Such vigilance can prevent the need for unnecessary invasive procedures and elucidate the natural history of these uncommon lesions.