Abstract
During the last three years, seven patients with severe intraventricular hemorrhage admitted to our clinic were treated with direct intraventricular infusion of urokinase. In each case, hemorrhage extended into the entire ventricular cavity and cast formation as well as an expansion of third and fourth ventricles were found. On the average, both the third and fourth ventricles became clear on the third day and the lateral ventricle on the ninth day after hemorrhage. Five of the seven patients showed good recovery or only moderate disability, and two died. Infection, convulsion, rebleeding, and peripheral or secondary hemorrhage due to the side effects of urokinase was not encountered during therapy.
We conclude that this procedure can be applied effectively and safely in severe intraventricular hemorrhage.
Similar content being viewed by others
References
Akdemir H, A Paşaoğlu, TE Patiroğlu: Lizis of intracranial hematomas with urokinase. Erciyes Med J 10 (1988) 199–208
Akdemir H, A Paşaoğlu, A Selçuklu et al: Local aspiration of primary intracerebral hematomas with urokinase. Dğa-TR J of Medical Sciences 16 (1992) 411–418
Doi E, H Moriwaki, N Komai et al: Sterotactic evacuation of intracerebral hematomas. Neurol Med Chir 22 (1982) 461–467
Graeb DA, WD Robertson, JS Lapointe et al: Computed Tomographic diagnosis of intraventricular hemorrhage: Etiology and prognosis. Radiology 143 (1982) 91–96
Ikeda Y, S Nakazawa, H Higuchi et al: Clinical aspects and prognosis of intraventricular hemorrhage with cerebrovascular disease — CT findings and etiological analysis. Neurol Med Chir 22 (1982) 822–828
Jennett B, H Bond: Assessment of outcome after severe brain damage. Lancet 1 (1975) 480–484
Kim CH, R Tanaka, K Kawakami et al: Traumatic primary intraventricular hemorrhage. Surg Neurol 16 (1981) 415–417
Little JR, GA Blomquist Jr, R Ethier: Intraventricular hemorrhage in adults. Surg Neurol 8 (1977) 143–149
Matsumoto K, C Honda: CT-guided sterotactic evacuation of hypertensive intracerebral hematomas. J Neurosurg 61 (1984) 440–448
Mohadjer M, R Eggert, M Johansen et al: CT-guided stereotactic fibrinolysis of spontaneous and hypertensive cerebellar hemorrhage long-term results. J Neurosurg 73 (1990) 217–222
Narayan RK, TM Narayan, DA Kaltz et al: Lysis of intracranial hematomas with urokinase in a rabbit model. J Neurosurg 62 (1985) 580–586
Niizuma H, T Otsuki, H Johkura et al: CT-guided sterotactic aspiration of intracerebral hematoma. Result of a hematoma-lysis method using urokinase. Appl Neurophysiol 48 (1985) 427–430
Pang D, RS Sclabassi, JA Horton: Lysis of intraventricular blood clot with urokinase in a canine model. Part 3: Effects of intraventricular urokinase on clot lysis and posthemorrhage hydrocephalus. Neurosurgery 190 (1986) 553–571
Ruscalleda J, A Peiro: Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage. Neuroradiology 28 (1986) 34–37
Teasdale G, B Jennett: Assessment of coma and impaired consciousness: a practical scale. Lancet 2 (1974) 81–84
Todo T, M Usui, K Takakura: Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. J Neurosurg 74 (1991) 81–86
Yagüe L, C Garcia-march, P Sanchez-Iedesma et al: Sterotactic evacuation and local administration in intracerebral hematomas. A comparative study. Acta Neurochir (suppl) 39 (1987) 45–48
Yamamoto Y, S Waga: Persistent intraventricular hematoma following ruptured aneurysm. Surg Neurol 17 (1982) 301–303
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Akdemir, H., Selçuklu, A., Paşaoğlu, A. et al. Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. Neurosurg. Rev. 18, 95–100 (1995). https://doi.org/10.1007/BF00417665
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00417665