• 12-years-old girl with spina bifida, hydrocephalus and shunt
• Presented with symptoms of raised intracranial pressure due to blocked shunt
• CT scan showed dilated ventricles. On sagittal reconstructions there was high riding basilar artery in contact with the middle aspect of the tuber cinereum
• Dilemma between shunt revision and ETV

EQUIPMENT USED

• Storz Decq endoscope with 0º optic lens
• Storz 3F single balloon catheter
• Storz articulated endoscope holder
• Storz 3CCD camera

SURGICAL TIPS

• Blunt perforation of the floor of the third ventricle in the direction of the dorsum sellae with the tip of the balloon catheter
• Visibility may be difficult
• Inspection of the stoma after perforation