Endoscopic third ventriculostomy: preoperative considerations and intraoperative strategy based on 300 procedures.

Purpose: Although successful endoscopic third ventriculostomy (ETV) has been reported for many indications, peculiarities of the surgical technique in each separate indication require particular respect.

Methods: A detailed account of the authors' surgical technique, their presurgical considerations, and their intraoperative strategies to perform ETV is presented. Surgery of representative obstructive hydrocephalus cases in posterior fossa lesions (cerebellar infarction, posterior fossa tumor), in distortion of the ventricular system (intracranial hemorrhage, basilar artery aneurysm) and in membranous obstruction (aqueductal stenosis, posterior fossa malformation), is illustrated in detail.