Not only endoscopic third ventriculostomy – management of aqueductal stenosis associated with pathologies of the pineal region

Pathologies of the pineal gland region are frequently encountered in daily neurosurgical practice. It is important to remember that, besides usually asymptomatic pineal gland cysts, neoplasms of a different origin may also occur in this region. The rarity of the most dangerous lesions – pineal gland apoplexy and pineal tumors – might cause problems with proper diagnosis and treatment. Their occurrence is commonly associated with symptomatic hydrocephalus caused by aqueductal stenosis. Currently, in such cases, endoscopic procedures, including endoscopic third ventriculostomy (ETV), are commonly and widely chosen as treatment options. Endoscopic procedures not only enable decompression of hydrocephalus but also further diagnosis of its cause. Herein, we present 3 case reports of endoscopic treatment with ETV performed in patients with hydrocephalus related to pineal region pathologies.