Introduction: Hydrocephalus (HCP) remains one of the commonest pathologies treated in developing countries. Endoscopic third ventriculostomy (ETV) has become the alternative to shunt-divergen procedures in the treatment of many pathologies of the cerebral fluid in the brain. Age has been considered a limitation to perform the procedure, we started to perform ETV In younger patients earlier than many other units. Objectives: In this study, we demonstrate the overall efficacy of ETV in infants younger than 1-year of age and to subsequently report the outcome of this procedure. Methods: From 2000 till 2016 we have performed a total of 386 cases of ETV of all ages. 71-cases were infants (below 1-year of age). Our study was undertaken to evaluate these cases. Patients were divided into two subgroups according to the cause of hydrocephalus; obstructive HCP, communicating HCP. Results: Mean time for follow up was 52 months. Mean age at surgery was 137days (7- 351days). The population included 31-females and 40-males, while10 infants were premature. Success rates were; 91.6%, 63.6% correspond to each sub-group with an overall success rate of 73.24%. Conclusion: ETV in infants is feasible, technically more demanding. Success rate justifies the procedure to be performed in such age group of patients. ETV can be used, attentively, in cases of hydrocephalus associated with MMC, morbidity and mortality does not differ from the general population.

IntroductionBrain tumors are of the most devastating forms of human disorders, particularly when they arise in the posterior fossa. The proximity of these lesions to the brainstem and fourth ventricle explains the common presentation of these patients. Obstructive hydrocephalus is described in about 80% of the cases, it can lead to herniation and death if left untreated [1][2][3][4][5][6][7].The best way to handle obstructive hydrocephalus secondary to posterior fossa tumor is still subject to debate. Approaches include preoperative insertion of a cerebrospinal fluid shunt or external ventricular drainage followed by surgical resection of the tumor [1,2,4,[6][7][8][9]. Others recommend treatment with corticosteroids and direct approach to the posterior fossa pathology, when possible [10][11][12][13][14][15][16][17].Endoscopy capitulates on improved visualization and permits effective surgical therapy of lesions in the nadirs of the brain with minimal collateral interruption of eloquent parenchyma. It is currently established popularity emulates the diversity of increasing applications, which are also reflective of integral challenges. Based on recent reports [6,7,13,18,19]. Neuroendoscopic treatment of hydrocephalus (endoscopic third ventriculostomy) is the most recent approach for management. In our center, we adopted the policy of performing a preoperative endoscopic third ventriculostomy (ETV) in cases of symptomatic hydrocephalus. Methods AbstractBackground: Brain neuroendoscopy has been introduced to our neurosurgical department since January 2000. Neuroendoscope was used to treat hydrocephalus secondary to posterior fossa tumours. In this study we expand on our previously published data to reassess and present our experience over the last sixteen years.