Flexible neuroendoscopy for percutaneous treatment of intraventricular lesions in the absence of hydrocephalus.

A procedure with a flexible fiberoptic neuroendoscope was applied to a series of patients with small lesions in the lateral ventricle, not associated with hydrocephalus. The maneuverability of the flexible neuroendoscope allows the surgeon to work in narrow spaces of the lateral ventricle avoiding surgical trauma to surrounding neural structures. The safety and accuracy of this procedure depend upon how available working space is obtained in the undilated ventricles. Both shaft-rotation and tip-flexion of the flexible neuroendoscope are available for adjusting it to the wider axis in each region of the lateral ventricle and for dealing with the intraventricular lesions. Three patients with a small intraventricular lesion, two with arachnoid cysts and one with subependymal hematoma, underwent such a procedure successfully. It is concluded that this neuroendoscopic procedure provides benefits to the treatment of small intraventricular lesions regardless of the size of the cerebral ventricles.