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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
"hydrocephalus"
symptom
achondroplasia
alexander disease
canavan disease
congenital toxoplasmosis
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
krabbe disease
monosomy 21
proteus syndrome
severe combined immunodeficiency
sneddon syndrome
von hippel-lindau disease
wiskott-aldrich syndrome
This symptom has already been validated