Choroid plexus cauterization on treatment of hydranencephaly and maximal hydrocephalus

• Published in: Child's nervous system Vol. 33; no. 9; pp. 1509 - 1516
• Main Authors: Pedrosa, Hugo Abi-Saber R., Lemos, Sandro P., Vieira, Carolli, Amaral, Leandro Custódio, Malheiros, José Augusto, Oliveira, Marcelo Magaldi, Gomez, Renato Santiago, Giannetti, Alexandre Varella
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2017
• Subjects: Cautery - methods; Child; Child, Preschool; Choroid Plexus - surgery; Female; Humans; Hydranencephaly - surgery; Hydrocephalus - surgery; Infant; Infant, Newborn; Male; Medicine; Medicine & Public Health; Neuroendoscopy - methods; Neurosciences; Neurosurgery; Original Paper; Retrospective Studies; Treatment Outcome; Choroid plexus; Neuroendoscopy; Hydrocephalus; Ventriculoperitoneal shunt; Hydranencephaly
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-017-3470-6

Introduction The standard treatment for hydranencephaly and maximal hydrocephalus consists of inserting shunts, although complications frequently occur. Choroid plexus cauterization (CPC) is an alternative, but its long-term efficacy and the factors associated with the success and failure of controlling head circumference (HC) are not well defined. Objective This study aims to evaluate the long-term efficacy and factors related to the success rate of CPC in the treatment of hydranencephaly and maximal hydrocephalus. Method Forty-two children with maximal hydrocephalus and hydranencephaly underwent CPC from 2006 to 2014 and were retrospectively evaluated. Children with less than 3 months of follow-up were excluded. The long-term efficacy and success rate of possible variables (i.e., sex, type of malformation, type of surgery performed, treatment hospital, age, and HC at the time of surgery and birth) were evaluated. Results Thirty-four children were considered for the effectiveness analysis. Treatment was successful in 24 children (70.6%), and failure occurred in 10 children (29.4%). Failure was detected soon after the endoscopic procedure (average 116 days). There was no difference in effectiveness when comparing the age at the moment of surgery ( p  = 0.473), type of malformation ( p  = 1), HC at birth (0.699), and HC at the time of surgery ( p  = 0.648). The surgical death rate was 7.14%. Conclusion Endoscopic CPC was a valid procedure used to treat hydranencephaly and maximal hydrocephaly, and it was effective in 70.6% of cases, with an average follow-up period of 32 months. When failures occurred, they occurred early. None of the analyzed variables interfered with the success of the treatment.