TREATMENT OF VILLOUS HYPERTROPHY OF THE CHOROID-PLEXUS BY ENDOSCOPIC CONTACT COAGULATION - TECHNICAL CASE-REPORT

Villous hypertrophy of the choroid plexus (VHCP) is a condition charac terized by overproduction of cerebrospinal fluid by bilaterally symmet ric and enlarged, yet histologically normal, choroid plexi. Medical an d surgical therapy have been met with variable success. Traditional sh unting procedures often result in failure to correct the underlying pr oblem as well as failure to absorb the large volume of fluid produced. Craniotomy for open surgical resection of the choroid is associated w ith considerable morbidity. The authors describe a technique of endosc opic contact coagulation as an effective and safe treatment of VHCP. A 14-month-old hydrocephalic girl with VHCP who failed ventriculoperito neal shunting as the sole treatment of her hydrocephalus presented wit h increasing ascites. She was successfully treated with ventriculoperi toneal shunting and endoscopic Bugby wire-directed monopolar contact c oagulation of the hyperplastic choroid plexus. Postoperatively her hea d circumference and cognitive development is normal for her age, and h er ascites has resolved. Endoscopic contact coagulation of the hyperpl astic choroid plexus is a minimally invasive surgical method which tre ats the cause of the CSF production while avoiding the operative compl ications of open choroid plexus resection.