Abstract
Introduction
It has been recognized that the morphological fetal CNS findings detected in early development are not always the final features: occasionally they may not be determined in diagnosis and may change developmentally or chronologically during the fetal life in utero.
Discussion
Certain factors of the fetal chronology of CNS anomalies can cause irreversible changes during fetal life. These include: significant delay in the neuronal maturation process in fetal hydrocephalus developed in clinico-embryological stage II of the Perspective Classification of Congenital Hydrocephalus (PCCH), secondary neural injury in the intactly developing spinal cord above the neural placode in fetuses with spina bifida aperta (myeloschisis), histological "evolution" of tumors or dysgenetic CNS, and deformity of the normally developed intracranial or intraspinal CNS structures. Considering the current status of fetal surgery in general and technical advances promising improved outcomes, fetal neurosurgery can also be applied to the above-mentioned progressive pathology or pathophysiology in the fetal CNS. However, since the failure of the first trial of fetal neurosurgery in the 1980s, the prerequisites have still not been clarified. In order to use advanced neurosurgery techniques in the management of fetal CNS anomalies, these prerequisites have to be established.
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References
Aikawa H, Kobayashi S, Suzuki K (1986) Aqueductal lesions in 6-aminonicotinamide-treated suckling mice. Acta Neuropathol (Berl) 71:243–250
Babapour B, Oi S, Klekamp J, Boozari B, Hussein S, Samii M (2002) Congenital hydrocephalus and associated hydromyelia—a pathological study in experimental rat model. Nerv Syst Child 27:243–249
Baxi L, Warren W, Collins MH, Timor-Tritsch IE (1990) Early detection of caudal regression syndrome with transvaginal scanning. Obstet Gynecol 75:486–489
Berry RJ (1961) The inheritance and pathogenesis of hydrocephalus-3 in the mouse. J Pathol Bacteriol 81:157–167
Broit A, Sidman RJ (1972) New mutant mouse with communicating hydrocephalus and secondary aqueductal stenosis. Acta Neuropathol (Berl) 21:316–331
Bronshtein M, Zimmer E, Gershoni-Baruch R, Yoffe N, Meyer H, Blumenfeld Z (1991) First- and second-trimester diagnosis of fetal ocular defects and associated anomalies: report of eight cases. Obstet Gynecol 77:443–449
Carton CA, Perry JH, Winter A, Tennyson V (1956) Studies of hydrocephalus in C57 blank mice. Trans Am Neurol Assoc 81:147–149
Clark FH (1932) Hydrocephalus: a hereditary character in the house mouse. Proc Natl Acad Sci USA 18:654–656
Clark SL, DeVore GR, Sabey PL (1988) Prenatal diagnosis of cysts of the fetal choroid plexus. Obstet Gynecol 72:585–587
Clewell WH, Johnson ML, Meier PR, Newkirk JB, Zide SL, Hendee RW, Bowes WA Jr, Hecht F, O'Keeffe D, Henry GP, Shikes RH (1982) A surgical approach to the treatment of fetal hydrocephalus. N Engl J Med 306:1320–1325
Comstock CH, Culp D, Gonzalez J, Boal DB (1985) Agenesis of the corpus callosum in the fetus: its evolution and significance. J Ultrasound Med 4:613–616
D'Agostino AN, Kernohan JW, Brown JR (1963) The Dandy-Walker syndrome. J Neuropathol Exp Neurol 22:450–470
Deol MS (1964) The origin of the abnormalities of inner ear in Dreher mice. J Embryol Exp Morphol 12:727–733
Depp R, Sabbagha RE, Brown JT, Tamura RK, Reedy NJ (1983) Fetal surgery for hydrocephalus: successful in utero ventriculoamniotic shunt for Dandy-Walker syndrome. Obstet Gynecol 61:710–714
Dinh DH, Wright RM, Hanigan WC (1990) The use of magnetic resonance imaging for the diagnosis of fetal intracranial anomalies. Childs Nerv Syst 6:212–215
Dohrmann GJ (1972) Cervical spinal cord in experimental hydrocephalus. J Neurosurg 37:538–542
Faulhauer K, Donauer E (1985) Experimental hydrocephalus and hydrosyringomyelia in the cat. Radiological findings. Acta Neurochir (Wien) 74:72–80
Fernell E, Uvebrant P, von Wendt L (1987) Overt hydrocephalus at birth—origin and outcome. Childs Nerv Syst 3:350–353
Gardner WJ (1965) Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neursurg Psychiatry 28:247–259
Green MC (1970) The developmental effects of congenital hydrocephalus (ch) in the mouse. Dev Biol 23:585–608
Gruneberg H (1943) Two new mutant genes in the house mouse. J Genet 45:22–28
Gruneberg H (1943) Congenital hydrocephalus in the mouse: a case of spurious pluritropism. J Genet 45:1–21
Hanigan WC, Gibson J, Kleopoulos NJ, Cusack T, Zwicky G, Wright RM (1986) Medical imaging of fetal ventriculomegaly. J Neurosurg 64:575–580
Higashi K, Noda Y, Mufune H (1987) Pathological studies on the brain of congenital hydrocephalic rats. Shoni No Noshinkei 12:1–9
Hill LM, Martin JG, Fries J, Hixson J (1991) The role of the transcerebellar view in the detection of fetal central nervous system anomaly. Am J Obstet Gynecol 164:1220–1224
Hirsch JF (1992) Surgery of hydrocephalus: past, present and future. Acta Neurochir (Wien) 116:155–160
Hoffman-Tretin JC, Horoupian DS, Koenigsberg M, Schnur MJ, Llena JF (1986) Lobar holoprosencephaly with hydrocephalus: antenatal demonstration and differential diagnosis. J Ultrasound Med 5:691–697
Kalter H (1963) Experimental mammalian teratogenesis, a study of galactoflavin-induced hydrocephalus in mice. J Morphol 112:303–317
Kirkinen P, Serlo W, Jouppila P, Ryynanen M, Martikainen A (1996) Long-term outcome of fetal hydrocephaly. J Child Neurol 11:189–192
Kohn DF, Chinookoswong N, Chou SM (1981) A new model of congenital hydrocephalus in the rat. Acta Neuropathol (Berl) 54:211–218
Koyama T (1970) Erzeugung von Missbildungen im Gehirn durch Methyl-Nutrisi-Harnstoff und Athyl-Nitrose-Harnstoff an SD-JCL Ratten. Arch Jpn Chir 39:233–254
Masters C, Alpers M, Kakulas B (1977) Pathogenesis of reovirus type 1 hydrocephalus in mice. Significance of aqueductal changes. Arch Neurol 34:18–28
McGahan JP, Phillips HE (1983) Ultrasonic evaluation of the size of the trigone of the fetal ventricle. J Ultrasound Med 2:315–319
McGahan JP, Haesslein HC, Meyers M, Ford KB (1984) Sonographic recognition of in utero intraventricular hemorrhage. Am J Roentgenol 142:171–173
Meuli M, Meuli-Simmen C, Hutchins GM, Yingling CD, Hoffman KM, Harrison MR, Adzick NS (1995) In utero surgery rescues neurological function at birth in sheep with spina bifida. Nat Med 1:342–347
Meuli M, Meuli-Simmen C, Yingling CD, Hutchins GM, Hoffman KM, Harrison MR, Adzick NS (1995) Creation of myelomeningocele in utero: a model of functional damage from spinal cord exposure in fetal sheep. J Pediatr Surg 30:1028–1033
Michejda M, Patronas N, Di Chiro G, Hodgen GD (1984) Fetal hydrocephalus. II. Amelioration of fetal porencephaly by in utero therapy in nonhuman primates. JAMA 251:2548–2552
Michejda M, Queenan JT, McCullough D (1986) Present status of intrauterine treatment of hydrocephalus and its future. Am J Obstet Gynecol 155:873–882
Monteagudo A, Reuss ML, Timor-Tritsch IE (1991) Imaging the fetal brain in the second and third trimesters using transvaginal sonography. Obstet Gynecol 77:27–32
Mori T (1985) A study of the tellurium-induced experimental hydrocephalus. Neuropathology 6:355–365
Nakayama DK, Harrison MR, Berger MS, Chinn DH, Halks-Miller M, Edwards MS (1983) Correction of congenital hydrocephalus in utero. I. The model: intracisternal kaolin produces hydrocephalus in fetal lambs and rhesus monkeys. J Pediatr Surg 18:331–338
Ohba N (1958) Formation of embryonic abnormalities of the mouse by a viral infection of mother animals. Acta Pathol Jpn 8:127–138
Oi S (1992) Is the hydrocephalic state progressive to become irreversible during fetal life? Surg Neurol 37:66–68
Oi S, Matsumoto S (1988) Natural history of subdural effusion in infants—prospective study of 87 cases. J Pediatr Neurosci 4:15–24
Oi S, Yamada H, Sasaki K et al (1985) [Diagnosis and treatment of fetal hydrocephalus. Problems in evaluation of the hydrocephalic state and selection for intrauterine shunt procedure.] Neurol Med Chir 25:195–202
Oi S, Yamada Y, Matsumoto S (1989) A prenatal CSF shunt procedure for fetal hydrocephalus, animal experimental model—pressure dynamics of intrauterine hydrocephalus and fetal ventriculo-mater peritoneal (FV-MP) shunt. Shoni No Noshinke (Jpn) 14:215–221
Oi S, Matsumoto S, Katayama K, Mochizuki M (1990) Pathophysiology and postnatal outcome of fetal hydrocephalus. Childs Nerv Syst 6:338–345
Oi S, Tamaki N, Kondo T et al (1990) Massive congenital intracranial teratoma diagnosed in utero. Childs Nerv Syst 6:459–461
Oi S, Tamaki N, Matsumoto S, Katayama K, Mochizuki M (1990) Prenatal neuroimaging in fetal dysraphism. Neurosonology 3:90–96
Oi S, Kudo H, Yamada H, Kim S, Hamano S, Urui S, Matsumoto S (1991) Hydromyelic hydrocephalus: correlation of hydromyelia with various stages of hydrocephalus in postshunt isolated compartments. J Neurosurg 74:371–379
Oi S, Sato S, Matsumoto S (1994) A new classification of congenital hydrocephalus: prospective classification of congenital hydrocephalous (PCCH) and postnatal prognosis. I. A proposal of a new classification of fetal/neonatal/infantile hydrocephalus based on neuronal maturation process and chronological changes. Jpn J Neurosurg 3:122–127
Oi S, Saito M, Tamaki N, Matsumoto S (1994) Ventricular volume reduction technique—a new surgical concept for the intracranial transposition of encephalocele. Neurosurgery 34:443–448
Oi S, Matsumoto S, Katayama K, Mochizuki M (1995) Pathophysiology and postnatal outcome of fetal hydrocephalus. Curr Trends Hydrol (Tokyo) 5:43–49
Oi S, Yamada H, Sato O, Matsumoto S (1996) Experimental models of congenital hydrocephalus and comparable clinical problems in the fetal and neonatal periods. Childs Nerv Syst 12:292–302
Oi S, Honda Y, Hidaka M, Sato O, Matsumoto S (1998) Intrauterine high-resolution magnetic resonance imaging in fetal hydrocephalus and prenatal estimation of postnatal outcomes with perspective classification. J Neurosurg 88:685–694
Oi S, Hidaka M, Honda Y, Togo K, Shinoda M, Shimoda M, Tsugane R, Sato O (1999) Neuroendoscopic surgery for specific forms of hydrocephalus. Childs Nerv Syst 15:56–68
Oi S, Babapour B, Klekamp J, Samii M (1999) Prerequisites for fetal neurosurgery: management of central nervous system anomalies toward the 21st century. Crit Rev Neurosurg 9:252–261
Platt LD, DeVore GR (1985) Modification of fetal intraventricular amniotic shunt. Am J Gynecol 152:1044–1045
Pretorius DH, Davis K, Manco-Johnson ML, Manchester D, Meier PR, Clewell WH (1985) Clinical course of fetal hydrocephalus: 40 cases. Am J Roentgenol 144:827–831
Raimondi AJ, Bailey OT, McLone DG, Lawson RF, Echeverry A (1973) The pathophysiology and morphology of murine hydrocephalus in hydrocephalus 3 and Ch mutants. Surg Neurol 1:50–55
Raimondi AJ, Clark SJ, McLone DG (1976) Pathogenesis of aqueductal occlusion in congenital murine hydrocephalus. J Neurosurg 45:66–77
Sasaki S, Goto H, Nagano H, Furuya K, Omata Y et al (1983) Congenital hydrocephalus revealed in the inbred rat. LEW/Jms. Neurosurgery 13:548–554
Sato K, Naomi N, Akira S, Shozo I (1985) Experimental production of myeloschisis, Chiari malformation type II, posterior fossa hydrocephalus and other malformation related to craniospinal dysraphism in rat fetuses by single intragastric administration of ethylenethiourea. Childs Nerv Syst 1:1–6
Saunders RL, Simmons GM, Edwards WH et al (1985) A cranial nail for fetal shunting. Childs Nerv Syst 1:185–187
Shinoda M, Hidaka M, Lindqvist E, Soderstrom S, Matsumae M, Oi S, Sato O, Tsugane R, Ebendal T, Olason L (2001) NGF, NT-3 and Trk C mRNAs, but not TrkA mRNA, are upregulated in the paraventricular structures in experimental hydrocephalus. Childs Nerv Syst 17:704–712
Takagi T, Hashimoto N, Togari H, Suzumori K (1988) [Holoprosencephaly with Dandy-Walker cyst diagnosed in utero by MRI: report of a case.] No To Hattatsu 20:237–241
Takahashi Y, Tsutsumi H, Hashi K (1990) Two cases of vein of Galen aneurysm in neonates: clinical problems and its treatment. Shoni No Noshinkei 15:253–260
Thickman D, Mintz M, Mennuti M, Kressel HY (1984) MR imaging of cerebral abnormalities in utero. J Comput Assist Tomogr 8:1058–1061
Tulipan N, Bruner JP (1999) Fetal surgery for spina bifida. Lancet 30:406
Tulipan N et al (1999) Intrauterine myelomeningocele repair reverses preexisting hind brain herniation. Pediatr Neurosurg 31:137–142
Yamada H, Oi S, Tamaki N, Matsumoto S, Sudo K (1992) Prenatal aqueductal stenosis as a cause of congenital hydrocephalus in the inbred rat. LEW/Jms. Childs Nerv Syst 8:394–398
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Oi, S. Diagnosis, outcome, and management of fetal abnormalities: fetal hydrocephalus. Childs Nerv Syst 19, 508–516 (2003). https://doi.org/10.1007/s00381-003-0790-5
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DOI: https://doi.org/10.1007/s00381-003-0790-5