Septostomy and Other Advanced Procedures

  • Pietro SpennatoEmail author
  • Giuseppe Mirone
  • Claudio Ruggiero
  • Raffaele Stefano Parlato
  • Giuseppe Cinalli
Living reference work entry


In the last years, indications to endoscopy have enlarged from simple obstructive hydrocephalus to the management of complex forms of hydrocephalus. Neuroendoscopy is now considered as the first-line treatment of several pathologies of the central nervous system, such as intracranial cysts, intraventricular septations, and isolated lateral and fourth ventricles. In this chapter, endoscopic surgical techniques used in the management of complex hydrocephalus are described, in particular: fenestration of septum pellucidum (septostomy), fenestration of intraventricular membranes, re-opening of Monro foramen (foraminoplasty), management of entrapped temporal horn, aqueductoplasty, and aqueductal stenting. Surgical anatomy, selection of the patient, preoperative planning, and complications avoidance are particularly stressed. Management of patients with multiloculated hydrocephalus still remain frustrating both for pediatric neurosurgeons and for patients and their families: endoscopic surgery has increased therapeutically options, improving prognosis, in a pathological condition in which historical treatments (shunting or open surgery) are largely disappointing.


Multiloculated hydrocephalus Complex hydrocephalus Septostomy Septum pellucidum Isolated fourth ventricle Aqueductoplasty Foraminoplasty 


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Pietro Spennato
    • 1
    Email author
  • Giuseppe Mirone
    • 1
  • Claudio Ruggiero
    • 1
  • Raffaele Stefano Parlato
    • 1
  • Giuseppe Cinalli
    • 1
  1. 1.Division of Pediatric Neurosurgery and Department of Neurosciences“Santobono-Pausilipon” Children’s HospitalNaplesItaly

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