title: Endoscopic coagulation of choroid plexus in three children with severely advanced forms of hydrocephalus.
abstract: OBJECTIVE
  The development of modern neuroendoscopic technology brought back the use of choroid plexus surgery for the treatment of some patients with hydrocephalus. This study explored the use of endoscopic coagulation of the choroid plexus (ECCP) for the treatment of severely advanced forms of hydrocephalus in three children.
  
  
  METHODS
  Three children with markedly dilated ventricles underwent ECCP. The first child had fetal hydranencephaly, the second had holoprosencephaly, and the third had severe hydrocephalus associated with other congenital malformations. All three children had had previous ventriculoperitoneal (VP) shunts, and ECCP was done because of shunt malfunction. All three children underwent computed tomography and magnetic resonance imaging to confirm the presence and to measure the size of the choroid plexus before surgery. ECCP was performed through a right frontal burr hole. A rigid neuroendoscope and monopolar coagulator were used to achieve choroid plexus coagulation.
  
  
  RESULTS
  The first child died 21 days after surgery because of generalized infection originating from the lungs. The second child needed a ventriculoatrial shunt 45 days after ECCP, and the third child needed VP shunt 3 months after ECCP.
  
  
  CONCLUSIONS
  ECCP, although not an alternative to ventricular shunt, is a safe procedure and should be tried in some children with severe advanced, low progressive, and hopeless forms of hydrocephalus. Long-term watchful follow-up is mandatory after surgery. When the risk of complications after VP shunting is relatively high in children with severe forms of hydrocephalus, ECCP seems to be worth trying. Delayed timing of VP shunting after ECCP would be meaningful for children with a high risk of shunt complications.
authors.affiliation: Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil.
authors.forename: Francinaldo L
authors.initials: FL
authors.lastname: Gomes
authors.affiliation: Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil.
authors.forename: Rafael Duarte de Souza
authors.initials: RD
authors.lastname: Loduca
authors.affiliation: Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil.
authors.forename: Marcia Noriko
authors.initials: MN
authors.lastname: Homa
authors.affiliation: Centro de Neurocirurgia Pediátrica (CENEPE), São Paulo, Brazil.
authors.forename: Nelci Zanon
authors.initials: NZ
authors.lastname: Collange
mesh_terms: D002648:Child; D002831:Choroid Plexus / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt