Simple and safe technique for endoscopic third ventriculocisternostomy

A simple and safe technique for performing an endoscopic third ventriculoci sternostomy is described using a small-diameter semirigid neuroendoscope in conjunction with a perforated ventricular catheter to bluntly fenestrate t he floor of the third ventricle, All previous descriptions involve the init ial use of an introducer sheath that in our experience lends to loss of cer ebrospinal fluid, consequently distorting the anatomic landmarks of the thi rd ventricle as well as compromising the crucial concave shape of its floor . Our technique limits the loss of cerebrospinal fluid volume, therefore, r educing the chance of basilar artery complex perforation as a consequence o f distortion of third ventricular landmarks and loss of third ventricular f loor concavity.