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Updated: Oct 27, 2025

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
Published on: June 28, 2024
Spontaneous third ventriculostomy in patients undergoing fetal surgery for myelomeningocele correction
Sergio Cavalheiro1,2, Marcos Devanir Silva da Costa3,4, Emmanuel de Oliveira Sampaio Vasconcelos E Sá1
1Department of Neurology and Neurosurgery, Federal University of São Paulo, Sao Paulo, Brazil.
Introduction:
Spontaneous third ventriculostomy (STV) is characterized by the spontaneous rupture of one of the ventricle walls due to increased pressure in the third ventricle caused by obstructive hydrocephalus. Clinically, STV results in resolution of signs and symptoms of intracranial hypertension and head circumference stabilization. No spontaneous STV cases in patients with myelomeningocele have been reported in the literature. The objective of this study was to report three cases of STV in patients with type 2 Chiari malformation who underwent intrauterine treatment.
Case Presentation:
All patients presented clinically with increased head circumference during outpatient follow-up. Only one patient required a ventriculoperitoneal shunt implantation. The other patients did not require further intervention.
Conclusion:
STV is a rare entity that is difficult to diagnose and should always be suspected in spontaneous hydrocephalus resolution, especially in early childhood. STV is not synonymous with hydrocephalus resolution.
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