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The role of endoscopic choroid plexus coagulation in the surgical management of bilateral choroid plexuses hyperplasia

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Abstract

Background

Bilateral choroid plexus hyperplasia is a rare condition often associated with cerebrospinal fluid (CSF) overproduction. CSF overproduction is usually so high that the placement of a CSF ventriculoperitoneal shunt almost always results in progressive ascites leading to the necessity of removing the inserted shunt device. A direct surgical treatment of the hyperplastic choroid plexuses is then mandatory. Endoscopic coagulation of the choroid plexuses has been recently proposed as an alternative to open surgical plexectomy. However, the effectiveness of the procedure in controlling CSF overproduction is still debated.

Technique

We report a case of bilateral choroid plexus hyperplasia in which an extensive bilateral endoscopic coagulation of the choroid plexuses failed to reduce the CSF formation rate sufficiently. A one-stage bilateral open surgical plexectomy was performed.

Results

The procedure succeeded to control CSF overproduction. Intraoperative blood loss during the surgical removal of the choroid plexuses was significantly reduced due to the previous coagulation of their surface.

Conclusion

On these grounds, we suggest that endoscopic choroid plexuses coagulation, even when failing to normalize CSF production, may still be considered as a valid adjuvant procedure in the management of this condition.

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References

  1. Aziz AA, Coleman L, Morokoff A, Maixner W (2005) Diffuse choroid plexus hyperplasia: an under-diagnosed cause of hydrocephalus in children? Pediatr Radiol 27

  2. Britz GW, Kyle Kim D, Loeser JD (1996) Hydrocephalus secondary to diffuse villous hyperplasia of the choroid plexus. Case report and review of literature. J Neurosurg 85:689–691

    PubMed  CAS  Google Scholar 

  3. Bucholz RD, Pittman T (1991) Endoscopic coagulation of the choroid plexus using the Nd:Yag laser: initial experience and proposal for management. Neurosurgery 28:421–427

    Article  PubMed  CAS  Google Scholar 

  4. Ceddia A, Di Rocco C, Carlucci A (1993) Idrocefalo congenito con iperproduzione liquorale da ipertrofia villosa del plesso corioideo associate a papilloma controlaterale. Minerva Pediatr 45:363–367

    PubMed  CAS  Google Scholar 

  5. D’Ambosio AL, O’Toole JE, Connolly ES Jr, Feldstein NA (2003) Villous hypertrophy versus choroid plexus papilloma: a case report demonstrating a diagnostic role for the proliferation index. Pediatr Neurosurg 39(2):91–96

    Article  PubMed  Google Scholar 

  6. Davis LE (1924) A physio-pathologic study of the choroid plexus with the report of a case of villous hypertrophy. J Med Res 44:421–534

    Google Scholar 

  7. Dandy WE (1918) Extirpation of the choroids plexus of the lateral ventricle in communicating hydrocephalus. Ann Surg 68:569–579

    Article  PubMed  CAS  Google Scholar 

  8. Di Rocco C, Iannelli A (1997) Poor outcome of bilateral congenital choroid plexus papillomas with extreme hydrocephalus. Eur Neurol 37:33–37

    Article  PubMed  Google Scholar 

  9. Fojimoto Y, Matsushita H, Plese JP, Marino R (2004) Hydrocephalus due to diffuse villous hyperplasia of the choroid plexus. Case report and review of literature. Pediatr Neurosurg 40:32–36

    Article  PubMed  Google Scholar 

  10. Fujimura M, Onuma T, Kameyama M, Motohashi O, Kon H, Yamamoto K, Ishii K, Tominaga T (2004) Hydrocephalus due to cerebrospinal fluid overproduction by bilateral choroids plexus papillomas. Childs Nerv Syst 20:485–488

    PubMed  Google Scholar 

  11. Goodhart GW (1918) Adenoma of the choroid plexus. Guys Hosp Rep 69:217–222

    Google Scholar 

  12. Hirano H, Hirahara K, Asakura T, T Shimozuru, Kadota K, Shimozuru T, Kadota K, Kasamo S, Shimohonji M, Kimotsuki K, Goto M (1994) Hydrocephalus due to villous hypertrophy of the choroid plexus in the lateral ventricles. J Neurosurg 80:321–323

    Article  PubMed  CAS  Google Scholar 

  13. Morota N, Fujihama Y (2004) Endoscopic coagulation of choroids plexus as treatment for hydrocephalus: indication and surgical technique. Childs Nerv Syst 20:916–820

    Article  Google Scholar 

  14. Philips MF, Shanno G, Duhaime AC (1998) Treatment of villous hypertrophy of the choroids plexus by endoscopic contact coagulation. Pediatr Neurosurg 28:252–256

    Article  PubMed  CAS  Google Scholar 

  15. Putnam TJ (1934) Treatment of hydrocephalus by endoscopic coagulation of the choroid plexus: description of a new instrument and preliminary report of results. N Engl J Med 210:1373–1376

    Google Scholar 

  16. Sugar O (2003) Demselben revisited. J Neurosurg 99:618–619

    PubMed  Google Scholar 

  17. Welch K, Strand R, Bresnam M, Cavazzuti V (1983) Congenital hydrocephalus due to villous hypertrophy of the choroid plexus. Case report. J Neurosurg 59:172–175

    PubMed  CAS  Google Scholar 

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Correspondence to Federico Di Rocco.

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Tamburrini, G., Caldarelli, M., Di Rocco, F. et al. The role of endoscopic choroid plexus coagulation in the surgical management of bilateral choroid plexuses hyperplasia. Childs Nerv Syst 22, 605–608 (2006). https://doi.org/10.1007/s00381-006-0070-2

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  • DOI: https://doi.org/10.1007/s00381-006-0070-2

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