Abstract | OBJECTIVE: METHODS: We prospectively collected clinical data from all untreated hydranencephalic and near hydranencephalic children from October 2006 to March 2008. All patients treated were randomly divided into 2 groups, ECPC or VPS, and submitted to either endoscopic choroid plexus cauterization or ventriculoperitoneal shunt placement. RESULTS: Seventeen patients were entered into the study. ECPC was completed in 9 patients; the procedure successfully controlled excessive head circumference and signs of increased intracranial pressure in 8 of these patients (88.8%). One endoscopic procedure in a hydranencephalic child failed after 7 months, resulting in VPS placement. Thus, of the 10 patients randomized to ECPC, 8 were treated successfully by ECPC (80%), and 2 went on to have a VPS. There were no complications related to this method of treatment. Seven children were randomized to the VPS group; and of these, 2 patients (28.5%) required shunt revisions during follow-up. There were no complications related to shunt placement. There was no difference in the success rate between patients randomized to ECPC and VPS, but the ECPC was more economical. CONCLUSION: ECPC is an acceptable alternative to VPS for treatment of hydranencephaly and near hydranencephaly. It is a single, definitive, safe, effective, and economical treatment that may avoid the complications of shunting.
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Authors | José Augusto Malheiros, Felipe Padovani Trivelato, Marcelo Magaldi Oliveira, Sebastião Gusmão, David Douglas Cochrane, Paul Steinbok |
Journal | Neurosurgery
(Neurosurgery)
Vol. 66
Issue 3
Pg. 459-64; discussion 464
(Mar 2010)
ISSN: 1524-4040 [Electronic] United States |
PMID | 20173541
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Topics |
- Adult
- Cerebral Ventricles
(surgery)
- Choroid Plexus
(surgery)
- Endoscopy
(methods)
- Female
- Follow-Up Studies
- Humans
- Hydranencephaly
(diagnosis, pathology, surgery)
- Male
- Prospective Studies
- Retrospective Studies
- Time Factors
- Treatment Outcome
- Ventriculoperitoneal Shunt
(methods)
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