Technical Notes & Surgical TechniquesTechnical and anatomical aspects of endoscopically assisted septostomy in unilateral ventriculoperitoneal shunt placement for the management of isolated lateral ventricles

•Endoscopic septostomy combined with shunting can be used to treat hydrocephalus due to obstruction of bilateral foramina of Monro.•Use of neuronavigation facilitates planning and intra-operative orientation during endoscopic septostomy.•MRI should be reviewed to determine the location of septal veins when planning endoscopic septostomy.•Variability in the preferred location of septostomy exists in the literature.

BackgroundIsolated lateral ventricle is a specific form of non-communicating hydrocephalus that is caused by an obstruction of the foramen of Monro. The condition was previously treated with bilateral shunt placement. However, the emergence of endoscopic surgery has provided more options in the management of this condition.Case description46-year-old female presented with obstructive hydrocephalus caused by a right thalamic primary central nervous system B-cell lymphoma. Endoscopic septostomy with unilateral shunt placement was performed because of bilateral foramen of Monro obstruction.ConclusionEndoscopic septostomy can be used as a tool to avoid bilateral shunt placement in certain cases of bilateral isolated lateral ventricles.