What Is Neuroendoscopy?

Neuroendoscopy is a surgical technique that involves using a long, thin tube called an endoscope to help doctors diagnose or treat conditions involving your brain, spine, or other parts of your nervous system.

In neuroendoscopy, using an endoscope allows doctors to make a small hole in your skull rather than removing a portion of your skull with traditional surgery.

Using neuroendoscopy techniques can treat various conditions in children and adults, such as brain tumors or structural differences in your brain present from birth. It can sometimes have a faster recovery time.

This article examines when doctors use neuroendoscopy and what to expect during the procedure.

Neuroendoscopy purpose

Doctors can use neuroendoscopy to diagnose or treat many conditions.

When used as a diagnostic tool, doctors can use the endoscope to see inside your body using a specific light and camera. They can also collect a biopsy of your tissue for testing in a laboratory.

They most commonly use neuroendoscopy in children and adults to treat:

• cerebrospinal fluid circulation disorders
• cysts on your brain
• tumors

Doctors can’t use neuroendoscopy to treat :

• acute or chronic subdural hematoma
• intraventricular hemorrhage (bleeding in the fluid-filled spaces in your brain)
• intraventricular infection
• changes in your nervous system’s form present from birth
• isolated fourth ventricle
• hydrocephalus

What are the benefits of neuroendoscopy?

Neuroendoscopy allows doctors to diagnose and treat conditions by creating a small hole in your skull rather than performing a craniotomy used in traditional surgery. A craniotomy involves removing a portion of your skull to access part of your brain or nervous system. But neuroendoscopy may offer advantages, such as:

• less tissue injury
• minimal brain dissection
• lower blood loss
• shorter surgical time

When is neuroendoscopy used?

Doctors can use neuroendoscopy to treat children and adults.

They can use neuroendoscopy in situations when it’s easier and safer to reach a surgical target with a long tube rather than by cutting deep to reach the area.

Neuroendoscopic procedures are different from endovascular procedures. Endovascular procedures are minimally invasive surgeries that involve repairing blood vessels or removing blood clots. Some endovascular brain procedures include brain aneurysm repair and intra-arterial thrombolysis for stroke treatment.

Neuroendoscopy side effects and risks

Neuroendoscopy might have fewer side effects than traditional surgery but can still lead to complications , such as:

• bleeding
• cerebrospinal fluid leak
• subdural hematoma and subdural hygroma
• infections
• pneumocephalus (air in the space around your brain)
• injury to an artery, cranial nerve, or to your hypothalamus
• reaction to the anesthetic
• seizures

A 2023 study suggested that adults had complication rates between 3.6% and 15%, and children had complication rates between 5.7% and 14.2%.

The risk of needing a second surgery seemed to be higher in children.

The most common complications of neuroendoscopy were cerebrospinal fluid infection in adults and seizures in children.

How effective is neuroendoscopy?

Neuroendoscopy can be an effective surgery for treating many conditions. Generally, planned procedures have higher success rates than surgeries performed in emergencies.

In the same 2023 study above, researchers found that neuroendocopy was either successful or didn’t worsen the underlying condition for 90.5% of children and 92.1% of adults.

In a 2024 study, researchers found that endoscopic third ventriculostomy was successful in 76% of 161 children treated for hydrocephalus.

Neuroendoscopy procedure

Your procedure can vary, depending on what condition you need surgery to treat.

Here’s a general idea of what to expect before a neuroendoscopic procedure to treat hydrocephalus, cerebrospinal fluid buildup in your brain’s ventricles.

Before neuroendoscopy

Doctors typically perform tests to measure your overall health before you have surgery.

Your doctor then gives you a general anesthetic , usually through a vein in your arm or wrist, to put you to sleep during your procedure.

During neuroendoscopy

Here’s what you can expect during an endoscopic third ventriculostomy procedure to treat hydrocephalus:

1. Your surgeon makes a small hole in your skull called a burr hole, usually on the right side.
2. The endoscope has a camera, and your surgeon watches the placement and manages the endoscope’s movement by watching a screen that follows the camera.
3. They pass the endoscope through the hole into a large space in your brain called a ventricle. This space allows cerebrospinal fluid to circulate through your brain.
4. Your surgeon then passes the endoscope through a channel connecting your ventricle to a smaller space called the third ventricle.
5. They puncture the third ventricle’s floor and inflate a small balloon to widen the hole.
6. Your surgeon removes the endoscope and balloon and stitches your wounds shut.

The procedure takes about 1 hour .

After neuroendoscopy

You may be sore following surgery, so your doctor can give you pain relievers. You may have dizziness and lightheadedness. You can leave the hospital when you can move without assistance and feel well.

Preparing for neuroendoscopy

Your surgeon can give you instructions before your procedure and allow you to ask questions. They may tell you to stop taking certain medications like blood thinners, and they can let you know how long in advance you need to stop eating.

Recovering from neuroendoscopy

Your recovery period depends on the surgery type you receive. People often stay in the hospital for 3 to 10 days after brain surgery. Avoid driving until you fully recover. It may take 6 weeks until it’s safe for you to travel by plane.

Neuroendoscopy recovery time

Your recovery time can depend on the procedure you receive. Children who receive an endoscopic third ventriculostomy may feel better within 1 to 2 weeks .

Are there any alternatives to neuroendoscopy?

Many conditions treated with neuroendoscopy can also be treatable with traditional surgery, which usually involves a craniotomy.

Hydrocephalus may also be treatable with shunting to improve cerebrospinal fluid flow through your brain.

How much does neuroendoscopy cost?

The cost of neuroendoscopic procedures can vary widely, depending on factors like the:

• condition needing treatment
• location where you live
• hospital’s location

In a 2017 study, researchers reported the average cost of endoscopic procedures to remove pituitary adenomas was $19,736 .

Many insurance providers, including government programs, provide coverage when brain surgery is medically necessary.

Takeaway

Neuroendoscopy is a surgical technique that involves using a long, thin tube called an endoscope to help doctors treat or diagnose conditions involving your brain or another part of your nervous system. Doctors use it to treat many conditions, such as hydrocephalus and brain tumors.

Neuroendoscopic procedures can sometimes have a faster recovery time and fewer side effects than traditional surgery. Your doctor can best advise you on your procedure’s potential risks.