Prenatal intervention in congenital obstructive hydrocephalus: Rationale, eligibility, and techniques

Congenital obstructive hydrocephalus from aqueductal stenosis (AS) is a relatively rare but clinically significant fetal anomaly that results from obstruction of the antegrade flow of cerebrospinal fluid (CSF) from the third to the fourth cerebral ventricles. Cerebrospinal fluid accumulates in the lateral and third ventricles under pressure. That pressure is transferred to the developing fetal brain, causing permanent neurologic injury from tissue ischemia and neuronal shear. This review aims to provide an in-depth analysis of the pathophysiology, diagnosis, and current management strategies, followed by the rationale, eligibility, and potential techniques of prenatal intervention.