endoscopic third ventriculostomy

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A third ventriculostomy is a type of surgical treatment for obstructive hydrocephalus, especially when obstruction is located at the level of the aqueduct of Sylvius (e.g. aqueduct stenosis). A permanent defect is created in the floor of the third ventricle anterior to the mammillary bodies, thus connecting the third ventricle with the interpeduncular cistern.

Follow up MRI studies may be necessary to confirm patency. This can be directly visualized on high resolution T2 weighted sagittal imaging and / or by performing CSF flow studies.

History and etymology

First developed in the early 1900s prior to advent of VP shunting, and at that time employed a subfrontal approach with sacrifice of the optic nerve! In 1923 a urologist by the name of William Mixter used a urethroscope to perform the first endoscopic ventriculostomy.