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

David I. Sandberg, Parthasarathi Chamiraju, Garrett Zoeller, Sanjiv Bhatia, John Ragheb

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)6-12
Number of pages7
JournalPediatric Neurosurgery
Volume48
Issue number1
DOIs
StatePublished - Oct 2012
Externally publishedYes

Keywords

  • Choroid plexus coagulation
  • Endoscopic management
  • Hydranencephaly
  • Third ventriculostomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

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