Neuroendoscopic septostomy for isolated lateral ventricle

The clinical features and endoscopic findings were investigated in 20 patients with isolated lateral ventricle treated by neuroendoscopic septostomy to establish cerebrospinal fluid communication and open an isolated ventricular compartment. The endoscopic procedure was incomplete because of thickened septum pellucidum and insufficient working space in two adults with postmeningitic hydrocephalus. Two children underwent second septostomy. In all other cases, results were good and there were no complications related to endoscopic procedures. Endoscopic septostomy is less invasive and has few complications. Intraoperative navigation and the biportal approach may be required in difficult cases with multiple septum formation and severe postmeningitic hydrocephalus. Adequate stomal size is required in high-risk groups including children under 2 years of age.