Isosorbide in the medical treatment of infantile hydrocephalus

John Lorber University of Sheffield, Sheffield, England

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✓ The author reports the methods, results and complications of isosorbide therapy in 60 patients with various types of infantile hydrocephalus. Treatment was monitored by serial measurements of head circumference, assessment of fontanel tension, air ventriculography, and echoencephalography. Frequent estimation of plasma electrolytes, urea, and Astrup figures were found essential to guard against serious hypernatremia and acidosis, especially if higher doses were used. Infants with moderate hydrocephalus and those whose shunt was removed temporarily because of infection did particularly well under isosorbide. Cases of severe hydrocephalus rarely responded to therapy and in these, at best, only a delay before surgical therapy was achieved.

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  • 1.

    Hayden PW, , Foltz EL, & Shurtleff DB: Effect of an oral osmotic agent on ventricular fluid pressure of hydrocephalic children. Pediatrics 41:955967, 1968 Hayden PW, Foltz EL, Shurtleff DB: Effect of an oral osmotic agent on ventricular fluid pressure of hydrocephalic children. Pediatrics 41:955–967, 1968

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  • 2.

    Hayden PW, & Shurtleff DB: The medical management of hydrocephalus. Develop Med Child Neurol (Suppl 27):5258, 1972 Hayden PW, Shurtleff DB: The medical management of hydrocephalus. Develop Med Child Neurol (Suppl 27):52–58, 1972

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  • 3.

    Huttenlocher PR: Treatment of hydrocephalus with acetazolamide: results in 15 cases. J Pediat 66:10231030, 1965 Huttenlocher PR: Treatment of hydrocephalus with acetazolamide: results in 15 cases. J Pediat 66:1023–1030, 1965

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  • 4.

    Lorber J: Medical and surgical aspects in the treatment of congenital hydrocephalus. Neuropaediatrie 2:239246, 1971 Lorber J: Medical and surgical aspects in the treatment of congenital hydrocephalus. Neuropaediatrie 2:239–246, 1971

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  • 5.

    Lorber J: Spina bifida cystica. Results of treatment of 270 consecutive cases with criteria for selection for the future. Arch Dis Child 47:854873, 1972 Lorber J: Spina bifida cystica. Results of treatment of 270 consecutive cases with criteria for selection for the future. Arch Dis Child 47:854–873, 1972

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  • 6.

    Lorber J: The use of isosorbide in the treatment of hydrocephalus. Develop Med Child Neurol (Suppl 27):8793, 1972 Lorber J: The use of isosorbide in the treatment of hydrocephalus. Develop Med Child Neurol (Suppl 27):87–93, 1972

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  • 7.

    Lorber J: Ventriculo-cardiac shunts in the first week of life: results of a controlled trial in the treatment of hydrocephalus in infants born with spina bifida cystica or cranium bifidum. Develop Med Child Neurol (Suppl 20):1322, 1969 Lorber J: Ventriculo-cardiac shunts in the first week of life: results of a controlled trial in the treatment of hydrocephalus in infants born with spina bifida cystica or cranium bifidum. Develop Med Child Neurol (Suppl 20):13–22, 1969

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  • 8.

    Lorber J, , Kalhan SC, & Mahgrefte B: Treatment of ventriculitis with gentamicin and cloxacillin in infants born with spina bifida. Arch Dis Child 45:178185, 1970 Lorber J, Kalhan SC, Mahgrefte B: Treatment of ventriculitis with gentamicin and cloxacillin in infants born with spina bifida. Arch Dis Child 45:178–185, 1970

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  • 9.

    Shurtleff DB, & Hayden PW: The treatment of hydrocephalus with isosorbide, an oral hyperosmotic agent. J Clin Pharmacol 12:108114, 1972 Shurtleff DB, Hayden PW: The treatment of hydrocephalus with isosorbide, an oral hyperosmotic agent. J Clin Pharmacol 12:108–114, 1972

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  • 10.

    Wealthall SR, , Hudson J, & Sherriff S: The effects of position, states of consciousness and drugs on cerebrospinal fluid absorption, estimated by I125 hippuran resorption. Develop Med Child Neurol (Suppl 27):140145, 1972 Wealthall SR, Hudson J, Sherriff S: The effects of position, states of consciousness and drugs on cerebrospinal fluid absorption, estimated by I125 hippuran resorption. Develop Med Child Neurol (Suppl 27):140–145, 1972

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  • 11.

    Wise BL, & Mathis JL: The effects of isosorbide on serum and cerebrospinal fluid osmolality and on the spinal fluid pressure in man. J Neurosurg 28:124128, 1968 Wise BL, Mathis JL: The effects of isosorbide on serum and cerebrospinal fluid osmolality and on the spinal fluid pressure in man. J Neurosurg 28:124–128, 1968

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  • 12.

    Wise BL, , Mathis JL, & Wright JH: Experimental use of isosorbide: an oral osmotic agent to lower cerebrospinal pressure and reduce brain bulk. J Neurosurg 25:183188, 1966 Wise BL, Mathis JL, Wright JH: Experimental use of isosorbide: an oral osmotic agent to lower cerebrospinal pressure and reduce brain bulk. J Neurosurg 25:183–188, 1966

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