Fetal intervention for neurological disorders: Indications and future developments

Abstract

Fetal intervention is indicated to treat selected neurological anomalies. The introduction of prenatal ultrasound and novel surgical techniques helped advance the use of fetal surgery for neurological disorders, most notably in cases of fetal myelomeningocele. Interventions for hydrocephalus (e.g. serial cephalocentesis, ventriculoamniotic shunts) were among the first treatments attempted by fetal surgeons, but results have been poor. Myelomeningocele is the most widely accepted neurological indication to offer fetal surgery, having recently been studied in a randomized controlled trial. Fetal intervention including prenatal gene and stem cell therapy holds promise for treating other neural tube defects and congenital neurovascular malformations, but further investigation is needed before new roles for fetal surgery are indicated.

Keywords

Fetal neurosurgery - fetal surgery - hydrocephalus - myelomeningocele - neural tube defect - prenatal surgery - spina bifida - ventriculomegaly