Pediatric neuroanesthesia. Neural tube defects

Neural tube defects of the brain and spinal cord, among the most common birth defects in the United States, cause neurologic morbidity from the lesions themselves and from associated hydrocephalus and Arnold-Chiari malformation. Because the myelomeningoceles, and encephaloceles are repaired surgically within hours of birth, neonatal anesthetic management with attention to fluids, body temperature, intravenous access, and monitoring is important. Anesthesia for treatment of hydrocephalus and Arnold-Chiari malformation takes into consideration the presence of intracranial hypertension and the need for manipulation of vital structures in the posterior fossa.