Endoscopic Techniques for Re-establishing Cerebrospinal Fluid Circulation in Ventricular Tumors

Background: Ventricular tumors frequently obstruct cerebrospinal fluid (CSF) pathways, resulting in hydrocephalus and increased intracranial pressure. Objective: To evaluate the effectiveness and outcomes of endoscopic techniques for reestablishing cerebrospinal fluid circulation in patients with ventricular tumors. Methods: This retrospective observational study was conducted at Aria institute of medical sciences Quetta from march 2025 to march 2026 and included 190 patients with ventricular tumors associated with obstructive hydrocephalus who underwent endoscopic intervention. Results: The mean age of patients was 24.8 ± 15.6 years, and 58.9% were male. The third ventricle was the most common tumor location (40.0%). Endoscopic third ventriculostomy was performed in 62.6% of patients, while endoscopic biopsy was performed in 44.2%. Successful restoration of CSF circulation was achieved in 163 (85.8%) patients, hydrocephalus improved in 158 (83.2%), and neurological improvement occurred in 149 (78.4%). Ventriculoperitoneal shunt placement was required in 22 (11.6%) patients. The mean hospital stay was 4.6 ± 2.3 days, and mortality was 2.6%. Younger age, shorter symptom duration, third ventricular tumors, endoscopic third ventriculostomy, and combined procedures were significantly associated with successful outcomes (p<0.05). Conclusion: Endoscopic techniques provide high rates of successful CSF circulation restoration with favorable neurological outcomes and low shunt dependency in patients with ventricular tumors.

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