Endoscopic Choroid Plexus Coagulation in Infants with Hydranencephaly or Hydrocephalus with a Minimal Cortical Mantle

• Published in: Pediatric neurosurgery Vol. 48; no. 1; pp. 6 - 12
• Main Authors: Sandberg, David I., Chamiraju, Parthasarathi, Zoeller, Garrett, Bhatia, Sanjiv, Ragheb, John
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.10.2012
• Subjects: Babies; Brain surgery; Cerebral Cortex - abnormalities; Cerebral Cortex - surgery; Choroid Plexus - pathology; Choroid Plexus - surgery; Female; Follow-Up Studies; Humans; Hydranencephaly - diagnosis; Hydranencephaly - surgery; Hydrocephalus - diagnosis; Hydrocephalus - surgery; Infant; Infant, Newborn; Male; Neuroendoscopy - methods; Neurological disorders; Original Paper; Pediatrics; Retrospective Studies; Surgical outcomes; Third Ventricle - pathology; Third Ventricle - surgery; Treatment Outcome; Ventriculostomy - methods; Third ventriculostomy; Choroid plexus coagulation; Hydranencephaly; Endoscopic management
• ISSN: 1016-2291; 1423-0305
• DOI: 10.1159/000339850

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.