Endoscopic choroid plexus coagulation in infants with hydranencephaly or hydrocephalus with a minimal cortical mantle.

Abstract

BACKGROUND/AIMS:

This study evaluates endoscopic choroid plexus coagulation, in conjunction with third ventriculostomy when technically feasible, as a strategy to treat patients with hydranencephaly or hydrocephalus with a minimal cortical mantle.

METHODS:

We retrospectively reviewed patients with hydranencephaly (n = 4) or hydrocephalus with the cortical mantle <1 cm in maximal thickness (n = 4) who underwent endoscopic choroid plexus coagulation from 2007 to 2010. Endoscopic third ventriculostomy was performed simultaneously when technically feasible (in 3 of 8 patients). Endoscopic management was considered successful if a shunt was not subsequently required.

RESULTS:

Endoscopic management was successful in 4 of 8 patients (50%) who did not require a shunt over a median follow-up period of 15 months (range 2.5-24). Four patients (50%) failed endoscopic management and required a shunt 1 month to 11 weeks after endoscopic surgery. One patient died 4 days after shunt placement due to pneumonia and renal failure. Three of 4 patients who had a successful endoscopic procedure ultimately died of causes that were likely unrelated to hydrocephalus (pneumonia in 2 patients and sudden infant death syndrome in 1 patient). Besides failure to control hydrocephalus adequately in 4 patients, there were no additional complications noted after endoscopic surgeries.

CONCLUSION:

Endoscopic choroid plexus coagulation can enable some infants with hydranencephaly or massive hydrocephalus to avoid a ventriculoperitoneal shunt.

• Authors: David I Sandberg, Parthasarathi Chamiraju, Garrett Zoeller, Sanjiv Bhatia, John Ragheb
• Journal: Pediatric neurosurgery (Pediatr Neurosurg) Vol. 48 Issue 1 Pg. 6-12 ( 2012) ISSN: 1423-0305 [Electronic] Switzerland
• PMID: 22832209 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Topics

• Cerebral Cortex (abnormalities, surgery)
• Choroid Plexus (pathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Hydranencephaly (diagnosis, surgery)
• Hydrocephalus (diagnosis, surgery)
• Infant
• Infant, Newborn
• Male
• Neuroendoscopy (methods)
• Retrospective Studies
• Third Ventricle (pathology, surgery)
• Treatment Outcome
• Ventriculostomy (methods)