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Radiosurgical Septostomy: A Technical Report of Two Cases.
Guillermo Axayacalt Gutierrez-Aceves1, Miguel Angel Celis-Lopez2, Sergio Moreno-Jimenez2
1Radioneurosurgery Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX.
Cureus
|November 14, 2025
Summary
Radiosurgical septostomy offers a minimally invasive treatment for asymmetric hydrocephalus. This precise radiosurgery technique effectively reduced ventricular dilation in two patients with meningioma, showing promising results.
Area of Science:
- Neurosurgery
- Radiosurgery
- Hydrocephalus Treatment
Background:
- Asymmetric hydrocephalus can lead to significant neurological complications.
- Traditional surgical interventions carry inherent risks.
- A minimally invasive alternative for septostomy is needed.
Purpose of the Study:
- To describe radiosurgical septostomy as a novel treatment for asymmetric hydrocephalus.
- To evaluate the safety and efficacy of radiosurgical septostomy in patients with meningioma-induced hydrocephalus.
Main Methods:
- Radiosurgical septostomy performed on the TrueBeam STX platform targeting the avascular portion of the septum pellucidum.
- Two male patients (46 and 64 years old) with meningioma and asymmetric hydrocephalus were treated.
- Prescribed doses of 120 Gy and 100 Gy were administered.
Main Results:
- Successful symptomatic and imaging improvement observed post-procedure.
- MRI confirmed a significant reduction in ventricular dilation over extended follow-up.
- No treatment failures or procedural complications were reported.
Conclusions:
- Radiosurgical septostomy is a highly precise, secure, and effective minimally invasive treatment modality.
- This technique presents a viable alternative for managing asymmetric hydrocephalus.
- Further research may expand its application in neurosurgical interventions.
