Through a nickel-sized opening in the skull, a small endoscope is passed into the spinal fluid containing lateral ventricle inside the brain. The tumor is identified and a piece can be removed for pathological examination. If the tumor is blocking the flow of spinal fluid (obstructive hydrocephalus) it is sometimes possible to combine the biopsy with endoscopic third ventriculostomy. This may help solve the problem caused by spinal fluid pressure build up at the same time as the biopsy.

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