In this study, we try to present our experience of transaqueductal removal of the fourth ventricular
neurocysticercosis (FVNCC) with a flexible
neuroendoscope. Three cases of the fourth ventricular
cysticercosis were transaqueductally removed with FUJINON EB-270P flexible
neuroendoscope through a frontal precoronal burr hole. The diagnosis was established on imaging and confirmed on histology in all of the cases. Complete excision of
cysts in the fourth ventricle was performed in all cases with no significant intraoperative or postoperative complications. The shunt and the string-of-beads multiple
cysts in the basal cistern were removed simultaneously through the orificium fistulae of the third ventricle floor with the flexible
neuroendoscope. Satisfactory postoperative CSF flow around foramen magnum was detected by cine phase-contrast magnetic resonance imaging. All of the patients were asymptomatic, with an average follow-up of 6 months. The whole ventricular system can be explored easily with electrical flexible
neuroendoscope. Endoscopic transaqueductal removal of the fourth ventricular
cysticercosis with a flexible
neuroendoscope should be recommended as the optimal choice of the disease due to its minimal invasion, fewer complications, shorter
length of stay and cheaper treatment costs.