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Abstract The telovelar approach should be the standard approach for lesions of the posterior fossa reaching the ventricle. The IMRI did help in diagnosing some complications or residual when GTR was planned, though the cost of the device and the setting is very high. In the developing countries like ours, using the iUS may be better option regarding the cost and no need for special setting. The ETV procedure should be familiar to junior staff to avoid the high shunt rates |