Endoscopic third ventriculostomy is a surgical procedure that may be offered to children and adults who have been diagnosed with obstructive or non-communicating hydrocephalus.
Shunting, or using a small silicone tubing to divert the cerebrospinal fluid (CSF) to a different body cavity for reabsorption, is the most common treatment for hydrocephalus and has been used for over 40 years. While shunts may be life saving, they are man-made devices and may fail for a variety of reasons.
Endoscopic third ventriculostomy is an alternative surgical procedure that creates a bypass for the cerebrospinal fluid in the head that eliminates the need for a shunt. It is helpful only to people with hydrocephalus that is caused by a blockage of the flow of cerebrospinal fluid.
Endoscopic means that the surgery is performed with the use of an endoscope. An endoscope is a thin tube that has a strong light, a powerful magnifying lens and a passage through which tiny instruments are passed.
Third ventriculostomy refers to the area of the brain where the bypass is made. Because the most common site of blockage is the narrow pathway between the third and fourth ventricle of the brain (the aqueduct of Sylvius), the bypass is made through the thin membrane in the bottom (or floor) of the third ventricle.
The cerebrospinal fluid may then flow from the lateral to the third ventricle and from the third ventricle through the new opening to the normal fluid chambers below the base of the brain.
The cerebrospinal fluid then flows up and over the surface of the brain where it is reabsorbed into the bloodstream.