PMID- 17918538
OWN - NLM
STAT- MEDLINE
DCOM- 20071119
LR  - 20220311
IS  - 0022-3085 (Print)
IS  - 0022-3085 (Linking)
VI  - 107
IP  - 3 Suppl
DP  - 2007 Sep
TI  - Choroid plexus hyperplasia: surgical treatment and immunohistochemical results. 
      Case report.
PG  - 255-62
AB  - Diffuse villous hyperplasia of the choroid plexus is a rare but potential source 
      of nonobstructive hydrocephalus. In addition to discussing the authors' staged 
      surgical approach and medical management decisions in a patient with this rare 
      and challenging condition, immunohistochemical studies of the choroid plexus 
      epithelium are presented to examine the pathophysiological factors involved in 
      abnormal cerebrospinal fluid (CSF) production in this disease. The patient, a 
      15-month-old girl born at 36 weeks' gestation, underwent a bilateral craniotomy 
      with resection of the choroid plexus to treat her villous hyperplasia. 
      Immunohistochemical studies of the resected choroid plexus were conducted for the 
      purpose of examining the carbonic anhydrase II (CAII) enzyme and the aquaporin 1 
      (AQP1) membrane protein. Results were compared with immunohistochemical studies 
      conducted in a small series of autopsy specimens of normal human choroid 
      plexuses. There was no change in the immunoreactivity of CAII in the patient with 
      villous hyperplasia compared with normal controls, whereas AQP1 immunoreactivity 
      was significantly weaker in the patient compared with normal controls. 
      Postoperatively, the patient's CSF overproduction resolved and her neurological 
      symptoms improved over time. Shunting techniques and presently available 
      pharmaceutical treatments alone do not provide adequate treatment of high-output 
      CSF conditions. Surgical removal of the affected choroid plexus is a feasible and 
      effective treatment. Results of the immunohistochemical studies reported here 
      support the suggestion that the CAII enzyme is retained in villous hyperplasia of 
      the choroid plexus. However, there appears to be decreased expression and perhaps 
      downregulation of AQP1 in villous hyperplasia compared with normal choroid 
      plexus. Future studies may elucidate the significance of these observations.
FAU - Smith, Zachary A
AU  - Smith ZA
AD  - Division of Neurosurgery, David Geffen School of Medicine at University of 
      California Los Angeles, California 90095-7039, USA.
FAU - Moftakhar, Parham
AU  - Moftakhar P
FAU - Malkasian, Dennis
AU  - Malkasian D
FAU - Xiong, Zhenggang
AU  - Xiong Z
FAU - Vinters, Harry V
AU  - Vinters HV
FAU - Lazareff, Jorge A
AU  - Lazareff JA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
RN  - 146410-94-8 (Aquaporin 1)
RN  - EC 4.2.1.1 (Carbonic Anhydrases)
SB  - IM
MH  - Aquaporin 1/metabolism
MH  - Carbonic Anhydrases/metabolism
MH  - *Cerebrospinal Fluid Shunts
MH  - Choroid Plexus/*pathology/*surgery
MH  - Female
MH  - Humans
MH  - Hydrocephalus/*pathology/*surgery
MH  - Hyperplasia
MH  - Immunohistochemistry
MH  - Infant
MH  - Magnetic Resonance Imaging
EDAT- 2007/10/09 09:00
MHDA- 2007/12/06 09:00
CRDT- 2007/10/09 09:00
PHST- 2007/10/09 09:00 [pubmed]
PHST- 2007/12/06 09:00 [medline]
PHST- 2007/10/09 09:00 [entrez]
AID - 10.3171/PED-07/09/255 [doi]
PST - ppublish
SO  - J Neurosurg. 2007 Sep;107(3 Suppl):255-62. doi: 10.3171/PED-07/09/255.