Surprasellar arachnoid cysts, which cause hydrocephalus by obstructing the foramina of Monro, can be marsupialized to the ventricular system endoscopically. This technique eliminates the need for inserting multiple shunts, and sometimes eliminates the need for shunting entirely. If one chooses to use a ventricular shunt, it can be inserted at the same sitting as the fenestration.
A middle age female was treated by endoscope in Neurosurgical Hospital- Baghdad without the need to insert a ventricular shunt.
