ABSTRACT
To document the experience of intraventricular neuroendoscopy in the diagnosis and management of intracranial lesions causing hydrocephalus as well as endoscopic third ventriculostomy [ETV] in treating hydrocephalus. Descriptive case series. Department of Neurosurgery, Peoples University of Medical and Health Sciences Nawabshah, from January 2009 to June 2011. Patients of hydrocephalus associated with intracranial lesions were enrolled. Lesions were resected using endoscopic approach or by microsurgical technique. Extra-axial lesions causing obstructive hydrocephalus were managed with microsurgical resection and ETV. Endoscopic third ventriculostomy was performed for persistent hydrocephalus. The study population consisted of 20 patients [13 males - 65% and 7 females - 35%]. The age ranged from 6 months to 70 year with the mean age of 21.6 year. Colloid cysts [n=2] and cystic craniopharyngioma [n=1] in third ventricle were completely excised. Third ventricular ependymoma was partially excised and referred for radiotherapy. Hydrocephalus was treated by ETV in 10 cases [50%], complete resection of the intraventricular lesions in 3 [15%] cases and ventriculoperitoneal [VP] shunt placement in 7 [35%] cases. VP shunt was avoided in 13 [65%] cases. ETV is an effective method of treating hydrocephalus associated with intracranial lesions. Intra-cranial extra-axial lesions can be effectively managed with microsurgical method. Intraventricular lesions can be resected or biopsied with neuroendoscopy providing a better minimal access with good illumination. VP shunt can be avoided in most of the cases.