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Obliteration of the choroid plexus after endoscopic coagulation.
MedLine Citation:
PMID:  24995821     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Object Endoscopic choroid plexus coagulation (CPC) with or without endoscopic third ventriculostomy (ETV) has been shown to be effective for selected patients with hydrocephalus. However, whether the effect of the coagulation is temporary and the choroid plexus regenerates or can be obliterated has remained largely unknown. The authors evaluate the effectiveness of CPC and report 3 cases of obliteration demonstrated by direct endoscopic observation. Methods The authors retrospectively analyzed the surgical results of patients with hydrocephalus primarily treated by CPC with or without ETV. Charts were reviewed for demographic data, clinical presentations, surgical therapies, and clinical outcomes. Results Eighteen patients with hydrocephalus were surgically treated using endoscopic CPC between July 2002 and July 2012. In 12 patients, ETV was concurrently performed. The etiology of hydrocephalus was posthemorrhagic in 5 patients, myelomeningocele in 3, postmeningitis in 2, congenital aqueductal stenosis in 1, hydranencephaly in 1, porencephaly in 1, and idiopathic in 5. The mean age at surgery was 8 months (range 0.3-24 months). The mean follow-up was 64 months. In 9 cases (50%), control of hydrocephalus was successful and the patients did not require further surgeries. In 9 patients (50%), treatment failed. Of these, 3 patients underwent repeat ETV 2, 3, and 38 months after the initial surgery. Endoscopic observation of the previous coagulation site revealed no regeneration of the choroid plexus in 2 patients, who underwent repeat ETV 2 and 3 months after CPC. In 1 patient who underwent repeat ETV 38 months after CPC, no regeneration of the choroid plexus, except for that in the proximity of the foramen of Monro, was observed. Conclusions Endoscopic CPC with or without ETV can be a safe and effective treatment alternative to shunt placement in infantile hydrocephalus. Obliteration of the choroid plexus can persist in the relatively long term following CPC, which may contribute to the long-term control of hydrocephalus in successful cases.
Authors:
Hideki Ogiwara; Kodai Uematsu; Nobuhito Morota
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-4
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  -     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-4     Citation Subset:  -    
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