Neurosurgery - Patient Care and Treatment

Penn State Children’s Hospital Pediatric Neurosurgery team offers prenatal counseling for fetal brain and spinal anomalies.

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Prenatal counseling for fetal brain and spinal anomalies

In the United States, the most common serious birth defects (malformations) involve openings of the skull and spine called open neural tube defects (ONTDs). ONTDs happen about one month after conception. The tissue that is to become the brain and spinal cord (the rod-like tissue running down the back of the embryo) is supposed to form a closed tube (the neural tube).

  • If the tube fails to form at the head, this causes an open skull and brain (anencephaly).
  • If the tube fails to form along the spinal cord, this causes an open spine and spinal cord (meningomyelocele or spina bifida).

Encephaloceles occur when the skull and surrounding tissues don’t form properly. This results in a closed, skin-covered sac that may contain variable amounts of brain tissue.

Hydrocephalus is another condition that can develop in the womb.

  • Hydrocephalus is an imbalance between the production and absorption of the fluid (cerebrospinal fluid or CSF) around the brain and spinal cord.
  • This imbalance results in too much CSF accumulating in the ventricles (small chambers) within the brain; this causes the ventricles to enlarge.
  • The outcome depends upon both the underlying cause and severity of the hydrocephalus.

Pediatric neurosurgeons treat ONTD and hydrocephalus after the baby is born. Expectant parents may meet with our experts before birth to learn about the potential treatments and outcomes of these malformations. We can also share information about prenatal (or fetal) repair of spina bifida and help make arrangements for this if families are interested and eligible.