Fetal neurosurgery.

Advances in antenatal diagnostic techniques coupled with innovative neurosurgical techniques have led to the consideration of treatment of major congenital neurological anomalies in utero. The rationale for such fetal neurosurgical intervention rests in the possibility of halting the progressive neurological deterioration and ameliorating the sequelae associated with severe congenital hydrocephalus and neural tube defects. Although the concept of in utero treatment of neurological anomalies remains more theoretical and experimental than clinically practical, preliminary evidence from both the laboratory and the clinic has begun to emerge to support continued efforts in this field. This review focuses on the role of neurosurgeons in surgery in utero. Emphasis is placed on advances in antenatal diagnosis, current research in surgery in utero, and potential clinical applications of fetal neurosurgery.