Endoscopic Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunt for Hydranencephaly and Near Hydranencephaly

Malheiros, José Augusto; Trivelato, Felipe Padovani; Oliveira, Marcelo Magaldi; Gusmão, Sebastião; Cochrane, D. Douglas; Steinbok, Paul

doi:10.1227/01.neu.0000365264.99133.ca

Cited by 33 publications

(30 citation statements)

References 20 publications

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“…1 The prospective study reported by Malheiros et al compared CPC with VP shunt placement in 17 infants with either hydranencephaly or near-hydranencephaly. 3 CPC successfully controlled head size in 8 of 9 infants. Of 7 children treated with VP shunts, 2 required shunt revisions during follow-up.…”

Section: Discussionmentioning

confidence: 90%

Choroid plexus coagulation in infants with extreme hydrocephalus or hydranencephaly

Shitsama

Wittayanakorn²,

Okechi³

et al. 2014

PED

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Object Severe hydrocephalus and hydranencephaly are common congenital conditions in Kenya. In patients with these conditions, ventriculoperitoneal (VP) shunts are associated with appreciable complications and endoscopic third ventriculostomies (ETVs) have limited success. Endoscopic choroid plexus coagulation (CPC) to diminish CSF production is a potential treatment option. The purpose of this study was to evaluate the effect of CPC without ETV in infants with severe hydrocephalus or hydranencephaly. Methods Medical records of infants with severe congenital hydrocephalus or hydranencephaly who underwent CPC in Kijabe Hospital from November 2010 to April 2013 were reviewed retrospectively. Thirty-three patients with complete medical records and preoperative radiographic images were identified. After CPC, the infants were followed in the Kijabe Hospital outpatient department, in mobile clinics, or by telephone. Success of the CPC was defined as resolution of preoperative symptoms, stabilization of head size, and avoidance of VP shunt placement. Results Patients were followed from 30 to 608 days (median of 120 days). Three patients were lost to follow-up. Of the 30 evaluable patients, CPC was considered to be successful in 13 (43.3%), including 8 of 20 patients with severe hydrocephalus and 5 of 10 with hydranencephaly. Failure of CPC was evident from increased head circumference in 14 (82%) of 17 patients and from CSF leakage in 3. Of the 17 failures, 13 occurred within 3 months of surgery. Six patients died: 3 whose CPC procedures were failures, 2 whose CPC was successful, and 1 postoperatively. Of the 17 in whom CPC failed, 10 subsequently underwent VP shunt insertion. Conclusions CPC stabilizes macrocephaly in approximately 40% of infants with severe congenital hydrocephalus and hydranencephaly and can be considered as an alternative to VP shunt placement.

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Section: Discussionmentioning

confidence: 90%

Choroid plexus coagulation in infants with extreme hydrocephalus or hydranencephaly

Shitsama

Wittayanakorn²,

Okechi³

et al. 2014

PED

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“…Hydranencephaly is a malformation of the central nervous system that results from errors of embryonic development post-neuralation (5). It has been proposed that the embryonic occlusion of the carotid arteries is the probable etiology of the disease based on the finding that only those structures supplied by posterior cerebral arteries form (3).…”

Section: Introductionmentioning

confidence: 99%

“…It has been proposed that the embryonic occlusion of the carotid arteries is the probable etiology of the disease based on the finding that only those structures supplied by posterior cerebral arteries form (3). The major and defining characteristics of hydranencephaly include an almost or complete lack of cortical mantle, specifically the cerebral hemispheres (3,5,8). It is generally accepted that in hydranencephaly, if there is any remaining cortex present, it will not be functioning (6,9).…”

Section: Introductionmentioning

confidence: 99%

Hydranencephaly: considering prolonged survival and treatment by endoscopic choroid plexus coagulation

Ray¹,

Mobley²,

Thompson³

et al. 2014

Turkish Neurosurgery

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Arachnoid collapse is a previously unreported complication of endoscopic choroid plexus coagulation (ECPC) treatment of hydranencephaly and is demonstrated in this case report. The variable anatomy found in hydranencephaly supports the use of ECPC as the preferred treatment option. However, the same anatomical anomalies predispose the procedure to this unique complication. A brief literature review of hydranencephaly has also been performed and is reported through the discussion. Neurosurgeons must be aware of this very dangerous complication and a discussion of preventative measures are made. The use of ECPC and the clinical expectations of treating patients with hydranencephaly is also discussed.

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“…We wish to point out that one of the larger series of choroid plexus coagulation (CPC) for hydranencephaly or near hydranencephaly [2] was not identified in their literature search and was not mentioned. This occurred because the terminology used for CPC in our prior report was endoscopic choroid plexus cauterization (ECPC) rather than coagulation.…”

mentioning

confidence: 99%

“…Nonetheless, we think the readers of the current review should be aware of our study [2], wherein we prospectively randomized infants with hydranencephaly and near hydranencephaly to have either ECPC or ventriculoperitoneal shunt (VPS). Of 17 patients, ten were randomized to receive ECPC.…”

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confidence: 99%

Re: Zhu X et al.: Choroid plexus coagulation for hydrocephalus not due to CSF overproduction: a review

2013

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Dear Editor: We congratulate the authors on a detailed review of choroid plexus coagulation for hydrocephalus [1]. We wish to point out that one of the larger series of choroid plexus coagulation (CPC) for hydranencephaly or near hydranencephaly [2] was not identified in their literature search and was not mentioned. This occurred because the terminology used for CPC in our prior report was endoscopic choroid plexus cauterization (ECPC) rather than coagulation. This does point out the importance of authors using terminology that is more commonly used, or at least having that term as a key word, so that the report will be picked up more readily in a literature search. In addition, the onus is on the authors of a review to avoid missing pertinent reports by using a search strategy that is not too specific and narrow.Nonetheless, we think the readers of the current review should be aware of our study [2], wherein we prospectively randomized infants with hydranencephaly and near hydranencephaly to have either ECPC or ventriculoperitoneal shunt (VPS). Of 17 patients, ten were randomized to receive ECPC. ECPC was technically successful in nine, of whom one failed and went on to VPS. We concluded that ECPC is an acceptable alternative to VPS for treatment of hydranencephaly and near hydranencephaly and may avoid the complications of shunting.

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Endoscopic Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunt for Hydranencephaly and Near Hydranencephaly

Abstract: ECPC is an acceptable alternative to VPS for treatment of hydranencephaly and near hydranencephaly. It is a single, definitive, safe, effective, and economical treatment that may avoid the complications of shunting.

Cited by 33 publications

References 20 publications

Choroid plexus coagulation in infants with extreme hydrocephalus or hydranencephaly

Choroid plexus coagulation in infants with extreme hydrocephalus or hydranencephaly

Hydranencephaly: considering prolonged survival and treatment by endoscopic choroid plexus coagulation

Re: Zhu X et al.: Choroid plexus coagulation for hydrocephalus not due to CSF overproduction: a review

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