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

Abstract

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.

Idiopathic cerebrospinal fluid overproduction: case-based review of the pathophysiological mechanism implied in the cerebrospinal fluid production

“…This procedure resulted in a significant reduction of CSF production, thus confirming its role in complicated cases of hydrocephalus (15). …”

Endoscopic third ventriculostomy and repeat endoscopic third ventriculostomy in pediatric patients: the Dutch experience

“…4,70 However, the possible favorable influence of choroid plexus cauterization in combination with ETV in developed countries is still being researched and debated and is beyond the scope of this study. 7,13,39,51,57,58,71 …”

John Edwin Scarff (1898-1978) and endoscopic choroid plexus coagulation: A historical vignette

“…During the late 1990s to early 2000s, advances in neurosurgical technology, anesthesia, and intensive care enabled safer endoscopic choroid plexus coagulation. [31] Combined with endoscopic third ventriculostomy, choroid plexus coagulation was revived by Warf and coworkers who reported their experience in African children through a large number of publications starting in 2005. [2526272829] The success rate for combined ETV and CPC was 66% for those younger than age 1 year and 80% for those older than age 1 year.…”

“…[30] In addition, choroid plexus coagulation is currently considered a well-established surgical treatment for hydrocephalus caused by CSF overproduction as in cases with choroid plexus hyperplasia. [31] With the well-known fact that CSF is not totally produced by the choroid plexus and is contributed by the ventricular lining as well as the interstitial space of the brain, it can be understood why choroid plexus ablation alone is not universally successful in treating many cases of hydrocephalus. Moreover, this has clearly allowed other surgical options like endoscopic third ventriculostomy and shunting to be utilized since they proved more effective in treating the vast majority of cases.…”