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Nonsurgical therapy for hydrocephalus: a comprehensive and critical review

Pharmacological interventions have been tested experimentally and clinically to prevent hydrocephalus and avoid the need for shunting beginning in the 1950s. Clinical trials of varied quality have not demonstrated lasting and convincing protective effects through manipulation of cerebrospinal fluid...

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Detalles Bibliográficos
Autores principales: Del Bigio, Marc R., Di Curzio, Domenico L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743412/
https://www.ncbi.nlm.nih.gov/pubmed/26846184
http://dx.doi.org/10.1186/s12987-016-0025-2
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author Del Bigio, Marc R.
Di Curzio, Domenico L.
author_facet Del Bigio, Marc R.
Di Curzio, Domenico L.
author_sort Del Bigio, Marc R.
collection PubMed
description Pharmacological interventions have been tested experimentally and clinically to prevent hydrocephalus and avoid the need for shunting beginning in the 1950s. Clinical trials of varied quality have not demonstrated lasting and convincing protective effects through manipulation of cerebrospinal fluid production, diuresis, blood clot fibrinolysis, or manipulation of fibrosis in the subarachnoid compartment, although there remains some promise in the latter areas. Acetazolamide bolus seems to be useful for predicting shunt response in adults with hydrocephalus. Neuroprotection in the situation of established hydrocephalus has been tested experimentally beginning more recently. Therapies designed to modify blood flow or pulsation, reduce inflammation, reduce oxidative damage, or protect neurons are so far of limited success; more experimental work is needed in these areas. As has been recommended for preclinical studies in stroke and brain trauma, stringent conditions should be met for preclinical studies in hydrocephalus. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12987-016-0025-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-47434122016-02-06 Nonsurgical therapy for hydrocephalus: a comprehensive and critical review Del Bigio, Marc R. Di Curzio, Domenico L. Fluids Barriers CNS Review Pharmacological interventions have been tested experimentally and clinically to prevent hydrocephalus and avoid the need for shunting beginning in the 1950s. Clinical trials of varied quality have not demonstrated lasting and convincing protective effects through manipulation of cerebrospinal fluid production, diuresis, blood clot fibrinolysis, or manipulation of fibrosis in the subarachnoid compartment, although there remains some promise in the latter areas. Acetazolamide bolus seems to be useful for predicting shunt response in adults with hydrocephalus. Neuroprotection in the situation of established hydrocephalus has been tested experimentally beginning more recently. Therapies designed to modify blood flow or pulsation, reduce inflammation, reduce oxidative damage, or protect neurons are so far of limited success; more experimental work is needed in these areas. As has been recommended for preclinical studies in stroke and brain trauma, stringent conditions should be met for preclinical studies in hydrocephalus. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12987-016-0025-2) contains supplementary material, which is available to authorized users. BioMed Central 2016-02-05 /pmc/articles/PMC4743412/ /pubmed/26846184 http://dx.doi.org/10.1186/s12987-016-0025-2 Text en © Del Bigio and Di Curzio. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Del Bigio, Marc R.
Di Curzio, Domenico L.
Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title_full Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title_fullStr Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title_full_unstemmed Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title_short Nonsurgical therapy for hydrocephalus: a comprehensive and critical review
title_sort nonsurgical therapy for hydrocephalus: a comprehensive and critical review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743412/
https://www.ncbi.nlm.nih.gov/pubmed/26846184
http://dx.doi.org/10.1186/s12987-016-0025-2
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