Chronic daily headache in a patient with cavum septum pellucidum and cavum verge.

Cavum septum pellucidum (CSP) and cavum Vergae (CV) are unusual variants and usually asymptomatic, but their expansion or inside lesions can produce symptoms by mass effect. A 46-year-old female Taiwanese worker presented with chronic daily headaches for eight years. Magnetic resonance imaging revealed coexistent CSP and CV. She declined surgical drainage recommended by a neurosurgeon and thus visited our clinic for a second opinion. Physical examination did not show any abnormality. With the help of the patient's one-month headache diary, she was diagnosed with chronic migraine according to the International Classification of Headache Disorders, 2(nd) edition, with further modification in 2006. In addition, hypertension was also identified. Over the following week, taking a daily selective β1-antagonist relieved the headache and hypertension. The medication was continued and the following year was uneventful. Therefore, the chronic daily headache was ascribed to chronic migraine, rather than symptomatic CSP and CV.