Bobble-head doll syndrome (BHDS) is a complex syndrome with the dominant symptom 
of repetitive anteroposterior head movement. Only 57 patients are quoted in the 
literature. The etiology of this syndrome remains unknown and no standard 
treatment has yet been established. We hereby report four cases treated at our 
department. All the patients presented a psychomotor retardation due to an 
obstructive hydrocephalus. All the patients were treated using neuroendoscopic 
techniques: two with ventriculocystostomy, and two with 
ventriculocystocisternostomy. Cyst decompression was achieved in all four cases 
and clinical recovery was evident in three of the four patients observed. After 
surgery, BHDS persisted longer the more the subsequent treatment was delayed. In 
this article, we provide a concise overview of the theories of pathogenesis, 
presentation, and management of this syndrome. Based on our own experience, we 
state that the method of choice should be the neuroendoscopy and this must be 
performed promptly after diagnosis is made.