Is the Choroid Plexus Needed?

Abstract

Background: Choroid plexectomy was first performed around 1910. Later on it was used in order to treat hydrocephalus while avoiding ventriculoperitoneal-shunt implantations and associated shunt revisions and became more important with improvement in endoscopic techniques and equipment. Yet little is known about the molecular-biological consequences ablation of a significant portion of the choroid plexus on metabolic brain homeostasis, neurogenesis and neuroimmunology. Summary: The physiological functions of choroid plexus in neurogenesis and neuroimmunology and its role in diseases, such as AD and MS, should alert to possible as yet to be determined consequences. Studies, both in children and in adults, are needed not only on the success in hydrodynamic stabilization of hydrocephalus, but also on the long-term outcome, especially premature neurodegeneration and inflammatory changes and on compensatory metabolic mechanisms. Key Messages: The value of choroid plexectomy for treatment of hydrocephalus in medically underserved areas should be remembered, yet when alternative treatment options are available we certainly cannot responsibly advocate against or for the use of choroid plexectomy. Therefore perhaps a more detailed discussion of risks and benefits of a choroid plexectomy with parents would be best to include the possible implications in brain development and function.