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inoperable tumors (for example, brainstem gliomas) or the first step before radiotherapy or surgical exploration of tumors of the pineal region.[4] This mechanism can be applied on the classic endoscopic third ventriculostomy and also for its emerging alternative procedures, these alternatives include subfrontal endoscopic fenestration of the lamina terminalis (EFLT), interhemispheric endoscopic fenestration of the lamina terminalis (IEFLT), and microsurgical third ventriculostomy by a minimally invasive supraorbital approach[5,6] b. Cystocisternostomy: The intentional fenestration of the cyst into the subarachnoid space was done for arachnoid cysts and Rathke’s cleft cysts, which were managed using drainage and cisternostomy[7] 2. Inflow corridor (cisternostomy proper): When the cisternostomy acts as a two‐way drainage pathway to allow egress of CSF to relax the brain during the skull base and microvascular procedures (it can be used in a variety of pathological conditions such as ruptured aneurysm, AVM, tumors, and intracerebral hemorrhage)[3] and also to the blood in the cortical subarachnoid aiming to equalize the intraparenchymal pressure with the intracisternal pressure in severe TBI. (In the current common practice, the surgical measures for TBI include external ventricular drainage insertion and decompressive craniectomy [DHC]. There is evidence that both of these measures reduce intracranial pressure, but the effect on the outcome, particularly in the long term, is equivocal. A new line of evidence supports cisternostomy as an emerging surgical treatment for TBI.)[3]

Cisternostomy in Neurosurgery: A New Proposed General Classification Based on Mechanism and Indications of the Cisternostomy Proper