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Child's Nervous System

, Volume 29, Issue 1, pp 35–42 | Cite as

Choroid plexus coagulation for hydrocephalus not due to CSF overproduction: a review

  • Xianlun Zhu
  • Concezio Di Rocco
Review Paper

Abstract

Objective

This study aims to review the role of choroid plexus coagulation (CPC) for hydrocephalus not due to CSF overproduction.

Methods

The literatures covering CPC/cauterization/extirpation and ablation searched through PubMed were reviewed.

Results

The history of CPC goes back to early 1900s by open surgery. It has evolved to mainly an endoscopic surgery since 1930s. With the development of other treatment methods and the understanding of CSF dynamics, the application of CPC dramatically decreased by 1970s. In late 2000, there was a resurgence of CPC in combination with endoscopic third ventriculostomy (ETV) performed in Africa.

Conclusions

CPC remains one of the options for the treatment of hydrocephalus in selected cases. CPC might provide a temporary reduction in CSF production to allow the further development of CSF absorption in infant. Adding CPC to ETV for infants with communicating hydrocephalus may increase the shunt independent rate thus avoiding the consequence of late complication related to the shunt device. This is important for patients who are difficult to be followed up, due to geographical and/or socioeconomic constrains. Adding CPC to ETV for obstructive hydrocephalus in infant may also increase the successful rate. Furthermore, CPC may be an option for cases with high chance of shunt complication such as hydranencephaly. In addition, CPC may act as an adjunct therapeutic measure for complex cases such as multiloculated hydrocephalus. In comparison with the traditional treatment of CSF shunting, the role of CPC needs to be further evaluated in particular concerning the neurocognitive development.

Keywords

Hydrocephalus Choroid plexus coagulation Choroid plexus extirpation Choroid plexus cauterization Choroid plexus ablation Endoscopic third ventriculostomy CSF production 

References

  1. 1.
    Di Rocco C, Iannelli A (1997) Poor outcome of bilateral congenital choroid plexus papillomas with extreme hydrocephalus. Eur Neurol 37:33–37PubMedCrossRefGoogle Scholar
  2. 2.
    Philips MF, Shanno G, Duhaime AC (1998) Treatment of villous hypertrophy of the choroid plexus by endoscopic contact coagulation. Pediatr Neurosurg 28:252–256PubMedCrossRefGoogle Scholar
  3. 3.
    Tamburrini G, Caldarelli M, Di Rocco F, Massimi L, D'Angelo L, Fasano T, Di Rocco C (2006) The role of endoscopic choroid plexus coagulation in the surgical management of bilateral choroid plexuses hyperplasia. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 22:605–608CrossRefGoogle Scholar
  4. 4.
    Warren DT, Hendson G, Cochrane DD (2009) Bilateral choroid plexus hyperplasia: a case report and management strategies. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 25:1617–1622CrossRefGoogle Scholar
  5. 5.
    Davis L (1939) Neurological surgery. Lea & Febiger, PhiladelphiaGoogle Scholar
  6. 6.
    Dandy WE (1918) Extirpation of the choroid plexus of the lateral ventricles in communicating hydrocephalus. Ann Surg 68:569–579PubMedCrossRefGoogle Scholar
  7. 7.
    Dandy WE (1932) The brain. WF Prior, HagerstownGoogle Scholar
  8. 8.
    Dandy WE (1938) The operative treatment of communicating hydrocephalus. Ann Surg 108:194–202PubMedCrossRefGoogle Scholar
  9. 9.
    Scarff JE (1966) Evaluation of treatment of hydrocephalus. Results of third ventriculostomy and endoscopic cauterization of choroid plexuses compared with mechanical shunts. Arch Neurol 14:382–391PubMedCrossRefGoogle Scholar
  10. 10.
    Milhorat TH (1974) Failure of choroid plexectomy as treatment for hydrocephalus. Surg Gynecol obstet 139:505–508PubMedGoogle Scholar
  11. 11.
    Griffith HB (1986) Endoneurosurgery: endoscopic intracranial surgery. Adv Tech Stand Neurosurg 14:2–24PubMedGoogle Scholar
  12. 12.
    Griffith HB, Jamjoom AB (1990) The treatment of childhood hydrocephalus by choroid plexus coagulation and artificial cerebrospinal fluid perfusion. Br J Neurosurg 4:95–100PubMedCrossRefGoogle Scholar
  13. 13.
    Pople IK, Ettles D (1995) The role of endoscopic choroid plexus coagulation in the management of hydrocephalus. Neurosurgery 36:698–701, discussion 701–692PubMedCrossRefGoogle Scholar
  14. 14.
    Albright L (1981) Percutaneous choroid plexus coagulation in hydranencephaly. Child’s brain 8:134–137PubMedGoogle Scholar
  15. 15.
    Morota N, Fujiyama Y (2004) Endoscopic coagulation of choroid plexus as treatment for hydrocephalus: indication and surgical technique. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 20:816–820CrossRefGoogle Scholar
  16. 16.
    Hahn FJ, Rim K (1976) Frontal ventricular dimensions on normal computed tomography. AJR Am J of Roentgenol 126:593–596Google Scholar
  17. 17.
    Wellons JC 3rd, Tubbs RS, Leveque JC, Blount JP, Oakes WJ (2002) Choroid plexectomy reduces neurosurgical intervention in patients with hydranencephaly. Pediatr Neurosurg 36:148–152PubMedCrossRefGoogle Scholar
  18. 18.
    Zuccaro G, Ramos JG (2011) Multiloculated hydrocephalus. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 27:1609–1619CrossRefGoogle Scholar
  19. 19.
    Oi S, Inagaki T, Shinoda M, Takahashi S, Ono S, Date I, Nomura S, Miwa T, Araki T, Ito S, Uchikado H, Takemoto O, Shirane R, Nishimoto H, Tashiro Y, Matsumura A (2011) Guideline for management and treatment of fetal and congenital hydrocephalus: Center of Excellence-Fetal and Congenital Hydrocephalus Top 10 Japan Guideline 2011. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 27:1563–1570CrossRefGoogle Scholar
  20. 20.
    Rekate HL (2011) A consensus on the classification of hydrocephalus: its utility in the assessment of abnormalities of cerebrospinal fluid dynamics. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 27:1535–1541CrossRefGoogle Scholar
  21. 21.
    Warf B, Ondoma S, Kulkarni A, Donnelly R, Ampeire M, Akona J, Kabachelor CR, Mulondo R, Nsubuga BK (2009) Neurocognitive outcome and ventricular volume in children with myelomeningocele treated for hydrocephalus in Uganda. J Neurosurg Pediatr 4:564–570PubMedCrossRefGoogle Scholar
  22. 22.
    Warf BC (2005) Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children. J Neurosurg 103:475–481PubMedGoogle Scholar
  23. 23.
    Warf BC, Campbell JW (2008) Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: long-term results of a prospective intent-to-treat study in 115 East African infants. J Neurosurg Pediatr 2:310–316PubMedCrossRefGoogle Scholar
  24. 24.
    Warf BC, Campbell JW, Riddle E (2011) Initial experience with combined endoscopic third ventriculostomy and choroid plexus cauterization for post-hemorrhagic hydrocephalus of prematurity: the importance of prepontine cistern status and the predictive value of FIESTA MRI imaging. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 27:1063–1071CrossRefGoogle Scholar
  25. 25.
    Warf BC, Dewan M, Mugamba J (2011) Management of Dandy–Walker complex-associated infant hydrocephalus by combined endoscopic third ventriculostomy and choroid plexus cauterization. J Neurosurg Pediatr 8:377–383PubMedCrossRefGoogle Scholar
  26. 26.
    Warf BC, Stagno V, Mugamba J (2011) Encephalocele in Uganda: ethnic distinctions in lesion location, endoscopic management of hydrocephalus, and survival in 110 consecutive children. J Neurosurg Pediatr 7:88–93PubMedCrossRefGoogle Scholar
  27. 27.
    Warf BC, Tracy S, Mugamba J (2012) Long-term outcome for endoscopic third ventriculostomy alone or in combination with choroid plexus cauterization for congenital aqueductal stenosis in African infants. J Neurosurg Pediatr 10:108–111PubMedCrossRefGoogle Scholar
  28. 28.
    Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, Stening W, Kwok B (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery 56:1271–1278, discussion 1278PubMedCrossRefGoogle Scholar
  29. 29.
    Teo C, Jones R (1996) Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg 25:57–63, discussion 63PubMedCrossRefGoogle Scholar
  30. 30.
    Kulkarni AV, Drake JM, Armstrong DC, Dirks PB (1999) Measurement of ventricular size: reliability of the frontal and occipital horn ratio compared to subjective assessment. Pediatr Neurosurg 31:65–70PubMedCrossRefGoogle Scholar
  31. 31.
    Pettorini BL, Tamburrini G (2007) Two hundred years of endoscopic surgery: from Philipp Bozzini’s cystoscope to paediatric endoscopic neurosurgery. Child’s nervous system: ChNS: official journal of the International Society for Pediatric Neurosurgery 23:723–724CrossRefGoogle Scholar
  32. 32.
    Warf BC, Kulkarni AV (2010) Intraoperative assessment of cerebral aqueduct patency and cisternal scarring: impact on success of endoscopic third ventriculostomy in 403 African children. J Neurosurg Pediatr 5:204–209PubMedCrossRefGoogle Scholar
  33. 33.
    Cserr HF (1971) Physiology of the choroid plexus. Physiol Rev 51:273–311PubMedGoogle Scholar
  34. 34.
    Weed LH (1914) Studies on cerebro-spinal fluid. No. IV: The dual source of cerebro-spinal fluid. J Med Res 31(93–118):111Google Scholar
  35. 35.
    Cushing H (1914) Studies on the cerebro-spinal fluid: I. Introduction. J Med Res 31:1–19PubMedGoogle Scholar
  36. 36.
    Bering EA Jr (1962) Circulation of the cerebrospinal fluid. Demonstration of the choroid plexuses as the generator of the force for flow of fluid and ventricular enlargement. J Neurosurg 19:405–413PubMedCrossRefGoogle Scholar
  37. 37.
    Di Rocco C, Pettorossi VE, Caldarelli M, Mancinelli R, Velardi F (1978) Communicating hydrocephalus induced by mechanically increased amplitude of the intraventricular cerebrospinal fluid pressure: experimental studies. Exp Neurol 59:40–52PubMedCrossRefGoogle Scholar
  38. 38.
    de Rougemont J, Ames A 3rd, Nesbett FB, Hofmann HF (1960) Fluid formed by choroid plexus; a technique for its collection and a comparison of its electrolyte composition with serum and cisternal fluids. J Neurophysiol 23:485–495PubMedGoogle Scholar
  39. 39.
    Welch K (1963) Secretion of cerebrospinal fluid by choroid plexus of the rabbit. Am J Physiol 205:617–624PubMedGoogle Scholar
  40. 40.
    Pollay M, Curl F (1967) Secretion of cerebrospinal fluid by the ventricular ependyma of the rabbit. Am J Physiol 213:1031–1038PubMedGoogle Scholar
  41. 41.
    Sonnenberg H, Solomon S, Frazier DT (1967) Sodium and chloride movement into the central canal of cat spinal cord. Proc Soc Exp Biol Med 124:1316–1320PubMedGoogle Scholar
  42. 42.
    Sato O, Bering EA (1967) Extra-ventricular formation of cerebrospinal fluid. No To Shinkei 19:883–885PubMedGoogle Scholar
  43. 43.
    Hammerstad JP, Lorenzo AV, Cutler RW (1969) Iodide transport from the spinal subarachnoid fluid in the cat. Am J Physiol 216:353–358PubMedGoogle Scholar
  44. 44.
    Milhorat TH, Hammock MK, Fenstermacher JD, Levin VA (1971) Cerebrospinal fluid production by the choroid plexus and brain. Science 173:330–332PubMedCrossRefGoogle Scholar
  45. 45.
    Milhorat TH, Hammock MK, Chien T, Davis DA (1976) Normal rate of cerebrospinal fluid formation five years after bilateral choroid plexectomy. Case report. J Neurosurg 44:735–739PubMedCrossRefGoogle Scholar
  46. 46.
    Oi S, Di Rocco C (2006) Proposal of “evolution theory in cerebrospinal fluid dynamics” and minor pathway hydrocephalus in developing immature brain. Childs Nerv Syst: ChNS: Off J of the Int Soc for Pediatr Neurosurg 22:662–669CrossRefGoogle Scholar
  47. 47.
    Oreskovic D, Klarica M (2011) Development of hydrocephalus and classical hypothesis of cerebrospinal fluid hydrodynamics: facts and illusions. Prog Neurobiol 94:238–258PubMedCrossRefGoogle Scholar
  48. 48.
    Sakka L, Coll G, Chazal J (2011) Anatomy and physiology of cerebrospinal fluid. European annals of Otorhinolaryngol Head and Neck Dis 128:309–316CrossRefGoogle Scholar
  49. 49.
    Redzic ZB, Segal MB (2004) The structure of the choroid plexus and the physiology of the choroid plexus epithelium. Adv Drug Deliv Rev 56:1695–1716PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Neurosurgery, Department of Surgery, Prince of Wales HospitalChinese University of Hong KongShatinPeople’s Republic of China
  2. 2.Department of NeurosurgeryUniversità Cattolica del Sacro CuoreRomeItaly

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