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Obliteration of the choroid plexus after endoscopic coagulation.
[hydrocephalus with stenosis of the aqueduct of sylvius]
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
.
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"myelomeningocele"
symptom
22q11.2 deletion syndrome
congenital diaphragmatic hernia
hirschsprung disease
hydrocephalus with stenosis of the aqueduct of sylvius
This symptom has already been validated