J Neurol Surg A Cent Eur Neurosurg 2015; 76(01): 25-29
DOI: 10.1055/s-0033-1345096
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Coagulation of Choroid Plexus in Three Children with Severely Advanced Forms of Hydrocephalus

Francinaldo L. Gomes
1   Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil
2   Hospital da Criança, Rede D'Or. Hospital São Luiz Jabaquara, São Paulo, Brazil
,
Rafael Duarte de Souza Loduca
1   Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil
2   Hospital da Criança, Rede D'Or. Hospital São Luiz Jabaquara, São Paulo, Brazil
,
Marcia Noriko Homa
1   Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil
2   Hospital da Criança, Rede D'Or. Hospital São Luiz Jabaquara, São Paulo, Brazil
,
Nelci Zanon Collange
1   Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil
2   Hospital da Criança, Rede D'Or. Hospital São Luiz Jabaquara, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

05 September 2012

14 January 2013

Publication Date:
07 November 2013 (online)

Abstract

Object The development of modern neuroendoscopic technology brought back the use of choroid plexus surgery for the treatment of some patients with hydrocephalus. This study explored the use of endoscopic coagulation of the choroid plexus (ECCP) for the treatment of severely advanced forms of hydrocephalus in three children.

Patients and Methods Three children with markedly dilated ventricles underwent ECCP. The first child had fetal hydranencephaly, the second had holoprosencephaly, and the third had severe hydrocephalus associated with other congenital malformations. All three children had had previous ventriculoperitoneal (VP) shunts, and ECCP was done because of shunt malfunction. All three children underwent computed tomography and magnetic resonance imaging to confirm the presence and to measure the size of the choroid plexus before surgery. ECCP was performed through a right frontal burr hole. A rigid neuroendoscope and monopolar coagulator were used to achieve choroid plexus coagulation.

Results The first child died 21 days after surgery because of generalized infection originating from the lungs. The second child needed a ventriculoatrial shunt 45 days after ECCP, and the third child needed VP shunt 3 months after ECCP.

Conclusions ECCP, although not an alternative to ventricular shunt, is a safe procedure and should be tried in some children with severe advanced, low progressive, and hopeless forms of hydrocephalus. Long-term watchful follow-up is mandatory after surgery. When the risk of complications after VP shunting is relatively high in children with severe forms of hydrocephalus, ECCP seems to be worth trying. Delayed timing of VP shunting after ECCP would be meaningful for children with a high risk of shunt complications.

 
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