Philips M F, Shanno G, Duhaime A C
The Children's Hospital of Philadelphia, One Children's Center, Philadelphia, Pa., USA.
Pediatr Neurosurg. 1998 May;28(5):252-6. doi: 10.1159/000028660.
Villous hypertrophy of the choroid plexus (VHCP) is a condition characterized by overproduction of cerebrospinal fluid by bilaterally symmetric and enlarged, yet histologically normal, choroid plexi. Medical and surgical therapy have been met with variable success. Traditional shunting procedures often result in failure to correct the underlying problem as well as failure to absorb the large volume of fluid produced. Craniotomy for open surgical resection of the choroid is associated with considerable morbidity. The authors describe a technique of endoscopic contact coagulation as an effective and safe treatment of VHCP. A 14-month-old hydrocephalic girl with VHCP who failed ventriculoperitoneal shunting as the sole treatment of her hydrocephalus presented with increasing ascites. She was successfully treated with ventriculoperitoneal shunting and endoscopic Bugby wire-directed monopolar contact coagulation of the hyperplastic choroid plexus. Postoperatively her head circumference and cognitive development is normal for her age, and her ascites has resolved. Endoscopic contact coagulation of the hyperplastic choroid plexus is a minimally invasive surgical method which treats the cause of the CSF production while avoiding the operative complications of open choroid plexus resection.
脉络丛绒毛状肥大（VHCP）是一种以双侧对称且增大但组织学正常的脉络丛产生过量脑脊液为特征的病症。药物和手术治疗的效果不一。传统的分流手术常常无法纠正潜在问题，也无法吸收产生的大量液体。开颅进行脉络丛开放手术切除会带来相当高的发病率。作者描述了一种内镜接触凝固技术，作为治疗VHCP的有效且安全的方法。一名患有VHCP的14个月大脑积水女孩，其脑积水仅通过脑室腹腔分流术治疗失败，出现了腹水增多的情况。她通过脑室腹腔分流术以及对增生性脉络丛进行内镜下Bugby线引导的单极接触凝固成功得到治疗。术后，她的头围和认知发育与其年龄相符，腹水也已消退。对增生性脉络丛进行内镜接触凝固是一种微创手术方法，可治疗脑脊液产生的原因，同时避免开放脉络丛切除的手术并发症。
