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Background: The application of endoscopic third ventriculostomy (ETV) for the treatment of obstructive hydrocephalus in shunt malfunction represents a paradigm shift, as it allows hydrocephalus to be transformed from a chronic condition treated with an artificial device to a curable disease. Methods: We present a 54-year-old male with a diagnosis of idiopathic Sylvian aqueduct stenosis treated with shunt. The patient presented to our institution with symptoms of shunt malfunction and an increase in ventricular size on imaging, which was his third episode throughout his life. Through a right precoronal approach, with prior informed consent from the patient, we performed foraminoplasty, endoscopic third ventriculostomy, and finally removal of the shunt system. Conclusion: ETV shows promise as a viable treatment option for shunt malfunction in noncommunicating obstructive hydrocephalic patients. Its potential to avoid VPS-related complications, preserve physiological CSF circulation, and provide an alternative drainage pathway warrants further investigation. [ABSTRACT FROM AUTHOR]

Discusses neurosurgical concepts of idiopathic normal pressure hydrocephalus (NPH). Endoscopic third ventriculostomy; Aqueduct stenosis; Clinical features; Heterogeneity of NPH; Lack of gold standard test; Similarity of NPH to other dementias.

Two cases are reported in which acute paraplegia developed subsequent to decompressive intracranial operations in patients with raised intracranial pressure and spinal cord tumours. Possible causative factors are discussed. [ABSTRACT FROM AUTHOR]