Control of hydrocephalus by endoscopic choroid plexus coagulation--long-term results and complications

Endoscopic choroid plexus coagulation has been used for the control of hydrocephalus regularly at this unit for the past 20 years. 156 of these operations have been performed on 116 patients and the aim of this study was to assess the rate of long-term control of hydrocephalus and the complications of the procedure. Data have so far been found for 98 patients with a median age at operation of 5 months (range 1 week-30 years). After a mean follow-up period of 10.5 years there were 32 (33%) patients continuing without a ventricular shunt. One patient developed papilloedema and required ventricular shunting 16 years after choroid plexus coagulation. There were no deaths resulting from operation. 5 patients developed post-operative meningitis and 3 patients had post-operative infections of implants (2 shunts and 1 reservoir). No cases of post-operative meningitis have occurred since vancomycin and gentamicin have been added to the solution used to perfuse the ventricles after operation (28 cases). Other complications included post-operative fits (2), respiratory arrest in a premature baby (10, low-pressure state (1), blocked or leaking external ventricular drain (4), drain displacement (4), subdural effusion (1) and per-operative minor ventricular bleeding forcing abandonment of the procedure (2).