Neuroendoscopic third ventriculostomy in the management of fourth ventricular outlet obstruction

Acquired fourth ventricular outlet obstruction, an uncommon entity, has bee n conventionally managed by ventriculoperitoneal shunt placements or excisi on of the obstructing membranes. The role of endoscopic third ventriculosto my is highlighted in the present communication. Three patients presenting w ith symptoms of raised intracranial pressure were diagnosed to have fourth ventricular outlet obstruction by neuroimaging studies and underwent endosc opic third ventriculostomy. Ail the patients had relief of their symptoms i n the postoperative period. Neuroimaging studies performed at follow-up rev ealed decrease in ventricular size in all. Endoscopic third ventriculostomy is a useful alternative in the management of acquired fourth ventricular o utlet obstruction.