title: Endoscopic choroid plexus coagulation in infants with hydranencephaly or hydrocephalus with a minimal cortical mantle.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Endoscopic choroid plexus coagulation can enable some infants with hydranencephaly or massive hydrocephalus to avoid a ventriculoperitoneal shunt.
authors: Division of Neurological Surgery, Departments of Pediatric Surgery and Neurosurgery, University of Texas-Houston, Children's Memorial Hermann Hospital, and Mischer Neuroscience Institute, Houston, Tex. 77030, USA. David.I.Sandberg@uth.tmc.edu
authors: David I
authors: DI
authors: Sandberg
authors: Parthasarathi
authors: P
authors: Chamiraju
authors: Garrett
authors: G
authors: Zoeller
authors: Sanjiv
authors: S
authors: Bhatia
authors: John
authors: J
authors: Ragheb
mesh_terms: D002540:Cerebral Cortex / Q000002:abnormalities / Q000601:surgery*; D002831:Choroid Plexus / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006832:Hydranencephaly / Q000175:diagnosis / Q000601:surgery*; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods