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Intraoperative endoscopic video of the lamina terminalis fenestration procedure. The video starts with a standard endoscopic third ventriculostomy and exploration of the basal cisterns. Very limited space for adequate CSF flow within the cisterns was noted. Proceeding with the LT fenestration, the tip of the flexible neuroendoscope is bent ventraly. The optic chiasm is identified. Utilizing a closed grasping forceps for the initial fenestration, the lamina terminalis is perforated. The ostomy is slowly enlarged with the neuroendoscope itself. The anterior communicating artery complex is identified. The ostomy is further enlarged if necessary. This video has been taken from Efficacy and Safety of Endoscopic Transventricular Lamina Terminalis Fenestration for Hydrocephalus, an article that can be read here http://journals.lww.com/neurosurgery/... . It was submitted by corresponding author Leonardo Rangel-Castilla, MD, from the Department of Neurosurgery at The Methodist Neurological Institute, The Methodist Hospital, Weill Cornell Medical College in Houston, Texas.