Loculated ventricles and isolated compartments in hydrocephalus: Their pathophysiology and the efficacy of neuroendoscopic surgery

Trapped cerebrospinal fluid spaces can, on occasion, complicate the management of hydrocephalus and present the surgeon with a treatment dilemma. This condition can be categorized into one of two types: those arising as a complication of shunting and those that arise as a complication of an inflammatory process within the ventricles. Whatever the cause, the result is a significant escalation in the complexity of the management of the patient. Neuroendoscopy is typically viewed as an attractive treatment alternative in such a setting because of its minimalistic and thus seemingly simplistic nature. We have learned that nothing could be further from the truth. This article reviews the various entities that can arise in the hydrocephalic patient, how they can be managed endoscopically, and what sort of result can be expected.