Intraventricular and periventricular lesions often result in obstructive hydrocephalus and can be effectively managed by ventriculoscopy. This avoids the significant risk of injury to vascular and neural structures that are encountered during open craniotomy and exposure of these deep lesions. It is important to consider endoscopic third ventriculostomy (ETV) in any adult patient with obstructive hydrocephalus given the significantly higher long-term success rate of primary ETV compared with VP shunts. Supervised training and mentorship are important in obtaining the skills and experience to safely perform ventriculoscopic procedures.
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