A series of neuroendoscopic third ventriculostomies in children less t
han 1 year old is reported. Twenty-seven patients underwent the proced
ure with 21 (77%) failing within a mean of 1.36 months of the procedur
e. Nineteen were subsequently shunted. The presence or absence of flow
through the ventriculostomy and the size of the lateral ventricles on
post-operative imaging were not an indicator of success or failure. O
nly 4 (15%) had a complication of the procedure. Although the majority
fail, approximately 1/3 are spared the added morbidity and mortality
of having a shunt. With such a low morbidity and zero mortality the pr
ocedure has many benefits over shunting. Consequently, neuroendoscopic
third ventriculostomy is used in this institution, where possible, ra
ther than a shunt.