Isosorbide in the management of infantile hydrocephalus.

Experience with 101 hydrocephalic infants treated primarily with isosorbide is reported. For those with moderate hydrocephalus the aim was to avoid shunt surgery, and this was achieved in 31 of the 43 infants. In cases with severe hydrocephalus or when the cerebrospinal fluid was abnormal the aim was to delay shunt surgery until the optimum time, with a lower risk of complications. Five of 48 such infants avoided shunts and 30 achieved a worthwhile delay. Nine other children were treated with isosorbide following shunt complications. Toxic effects were infrequent, not severe, and reversible on stopping treatment or reducing dosage. 63 infants eventually had shunts inserted.