The septum pellucidum is a thin neuroglial plate located between the frontal horns of both ventricles. During fetal life, there is a gap between the two plates, which is called the septal cavity. In most people, the cavity closes before (after) birth, but only 15%-20% of adults have the cavity, which is also called the fifth ventricle. The cystic cavity is usually asymptomatic as it communicates with the lateral ventricles. Due to intracranial infection, hemorrhage, etc., the traffic port is adhered to form a non-traffic cyst, which increases in size and obstructs the interventricular foramen and appears as high cranial pressure and hydrocephalus. In the past, septal cavities, verga cavities, septal cysts, and verga cysts were collectively referred to as “septal cavities”. shaw pointed out that the cavity between the two walls of the septum must be at least 1 mm wide to be called a septal cavity and considered septal cavities to be a normal variant. It is generally accepted that septal cysts (SPC) can be divided into two categories: asymptomatic septal cysts (ASPC) and symptomatic septal cysts (SSPC), which are also known as dilated septal cysts (ESPC); ASPCs are usually found incidentally during physical examination; ESPCs may cause clinical symptoms such as blockage of interventricular foramen, distorted displacement of deep brain vessels, and compression of hypothalamus and optic cross. The diagnosis of ESPC does not rely on imaging data alone, but ignores clinical symptoms, especially in infants and children, and it is often difficult to determine whether it is combined with other diseases [3]. The diagnosis of ESPC cannot be made solely on the basis of imaging data, ignoring clinical symptoms. ASPC usually requires no treatment, but periodic examinations and dynamic observation are sufficient; once the diagnosis of ESPC is confirmed, surgical treatment is required. There are many methods of surgical treatment, such as craniotomy, cyst wall opening, cyst-lateral ventricular shunt, and lateral ventricular-abdominal shunt, which have been widely used, but they need to be improved because of the large surgical trauma, postoperative reactions, and complications. The development of microinvasive neurosurgery, especially the advancement of stereotactic technology, has made the surgical treatment of this disease easier, more accurate, and safer. CT-guided brain stereotactic cyst wall stoma therapy has its obvious advantages: (1) the cyst wall stoma permanently connects the cyst to the ventricle, eliminating the compression of the cyst on the surrounding structures and achieving symptomatic relief. (2) Direct cyst wall stoma is easier than cyst|ventricular shunt and less disturbing to the ventricles. ③The use of unilateral or bilateral permanent multi-target stoma during surgery can effectively prevent recurrence. ④Surgical injury is small, postoperative reaction is mild, and there are no complications. When performing this procedure, attention must be paid to the following: during the directional surgery, the bone hole should be positioned at a certain distance from the median sagittal line so that the puncture direction forms a certain angle with the median sagittal plane to avoid slipping along the hyaline septum when the radiofrequency needle approaches the target point. At the same time, it is better to use the pointed end of the radiofrequency needle so that it is easier to puncture the cyst wall. For patients with large cysts, combined bilateral hydrocephalus and minors, bilateral stoma is preferred to ensure permanent access. In addition, precise calculation of target coordinates, proper operation of the directional instrument and strict control of RF temperature and time are also crucial to the success of the directional surgery. patients with ESPC generally have a good prognosis as long as they are seen promptly.