In the period of January 2003-September 2006 96 cases with the diagnosis of internal hydrocephalus, being at paediatric age, were operated in the 1st Neurosurgical Department. Obstructive hhydrocephalus was present in 39 cases, the most frequent cases being noted in the context of Arnold-Chiari type II malformation, (18 cases), brain tumours (9 cases), congenital stenosys of the apeduct documented imagistic (5 cases) and intraventricular haemorrhage (3 cases). In the majority of the cases the cause of the hydrocephalus was not documented, except 9 cases of meningitis. In this paper surgical solutions are presented in order to decrease the risks of the contamination of the drainage system, as well our option to perform surgery within the same anaesthesia both for the hydrocephalus and the meningomiellel in the cases of Arnold -Chiari type II malformation. A number of 5 cases beneficiated of ventriculocisternostomy and ventriculo-peritoneal drainage endoscope assisted, solution, which is our opinion allows a more efficient solution of the cases of secondary hydrocephalus to meningitis or haemorrhage.