Skip to main content
SpringerLink
Log in

Urokinase infusion for severe intraventricular haemorrhage

  • Special Case
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The purpose of this study was to explore in patients with intraventricular haematomas the effectiveness and complication rate of a treatment protocol including standard ventriculostomy and application of urokinase via the catheter.

Our series includes 16 patients with severe CT-diagnosed intraparenchymal and predominantly intraventricular haemorrhages. In all cases, ventricular drainage was performed. Urokinase treatment was started immediately with intraventricular infusions of 10,000 U urokinase in 5 ml sterile physiological saline every 12 hours. Twelve patients had an excellent outcome, three good and one poor. There were no complications related to urokinase therapy. Side efects of the infusion volume were profuse sweating and headache which were present at 10 ml total infusion volume, but disappeared after reduction to 5 ml. A group of five patients with comparable lesions treated only with ventriculostomy served as controls. Two of them had a good outcome, two a poor one and one died. The late results in the urokinase-treated group were also favourable. Only one of the patients developed hydrocephalus and was shunted. In the control group, two patients required shunting for delayed hydrocephalus.

We conclude that this protocol for urokinase treatment is safe and effective and can be used in almost all patients with intracerebroventricular haemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Douglas MA, Haerer AF (1982) Long-term prognosis of hypertensive intracerebral haemorrhage. Stroke 13: 448–491

    PubMed  Google Scholar 

  2. Fleischer AS, Huhn SL, Meislin H (1988) Post-traumatic acute obstructive hydrocephalus. Ann Emerg Med 17: 165–167

    PubMed  Google Scholar 

  3. Graeb DA, Robertson WD, Lapointe JS, Nugent RA, Harrison PB (1982) Computed tomographic diagnosis of intraventricular haemorrhage. Radiology 143: 91–96

    PubMed  Google Scholar 

  4. Hayashi M, Handa Y, Kobayashi H, Kawano H, Nozaki J, Hirose S (1988) Prognosis of intraventricular haemorrhage due to hypertensive haemorrhagic cerebrovascular disease. Zentralbl Neurochir 49: 101–108

    PubMed  Google Scholar 

  5. Jayakumar PN, Taly AB, Bhavani UR, Arya BYT, Nagaraja D (1989) Prognosis in solitary intraventricular haemorrhage. Acta Neurol Scand 80: 1–5

    PubMed  Google Scholar 

  6. Kim CH, Tanaka R, Kawakami K, Ito J (1981) Traumatic primary intraventricular haemorrhage. Surg Neurol 16: 415–417

    Google Scholar 

  7. Little JR, Blomquist GA, Ethier R (1977) Intraventricular haemorrhage in adults. Surg Neurol 8: 143–149

    PubMed  Google Scholar 

  8. Matsumoto K, Hondo H (1984) CT-guided stereotactic evacuation of hypertensived intracerebral haematomas. J Neurosurg 61: 440–448

    PubMed  Google Scholar 

  9. Nakajima S, Mizuno M, Sampei T, Suzuki A, Yasui N (1990) Intraventricular haematomas associated with hypertensive intracerebral haemorrhages: with special reference to third ventricular haematoma. No Shinkei Geka 18: 1107–1113

    PubMed  Google Scholar 

  10. Narayan RK, Narayan TM, Katz DA, Kornblith PL, Murano G (1985) Lysis of intracranial haematomas with urokinase in a rabbit model. J Neurosurg 62: 580–586

    PubMed  Google Scholar 

  11. Nath FP, Nicholls D, Fraser RJA (1983) Prognosis in intracerebral haemorrhage. Acta Neurochir (Wien) 67: 29–35

    Google Scholar 

  12. Ojemann RG, New PFJ (1963) Spontaneous resolution of an intraventricular haematoma. J Neurosurg 20: 899–902

    PubMed  Google Scholar 

  13. Pia HW (1972) The surgical treatment of intracerebral and intraventricular haematomas. Acta Neurochir (Wien) 27: 149–164

    Article  Google Scholar 

  14. Portenoy RK, Lipton RB, Berger AR, Lesser ML, Lantos G (1987) Intracerebral haemorrhage: a model for the prediction of outcome. J Neurol Neurosurg Psychiatry 50: 976–979

    PubMed  Google Scholar 

  15. Ruscalleda J, Peiro A (1986) Prognostic factors in intraparenchymatous haematoma with ventricular haemorrhage. Neuroradiology 28: 34–37

    PubMed  Google Scholar 

  16. Shen PH, Matsuoka Y, Kawajiri K, Kanai M, Hoda K, Yamamoto S, Nishimura S (1990) Treatment of intraventricular haemorrhage using urokinase. Neurol Med Chir (Tokyo) 30: 329–333

    Google Scholar 

  17. Stalhammar D, Starmark J-E, Holmgren E, Erkisson N, Nordström CH, Fedders O, Rosander B (1988) Assessment of responsiveness in acute cerebral disorders. A multicentre study on the Reaction Level Scale (RLS 85). Acta Neurochir (Wien) 90: 73–80

    Google Scholar 

  18. Toto T, Usui M, Takakura K (1991) Treatment of severe intraventricular haemorrhage by intraventricular infusion of urokinase. J Neurosurg 1991: 81–86

    Google Scholar 

  19. Yagüte L, Garcia-March G, Paniagua C, Sanchez-Ledesma MJ, Diaz P, Ludena D, Maillo A, Broseta J (1987) Stereotactic evacuation and local administration in intracerebral haematomas. A comparative study. Acta Neurochir (Wien) [Suppl] 39: 45–48

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurosurgical Department, Martin-Luther-University, Halle, Federal Republic of Germany

    N. G. Rainov M.D. & W. L. Burkert

Authors
  1. N. G. Rainov M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. L. Burkert
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rainov, N.G., Burkert, W.L. Urokinase infusion for severe intraventricular haemorrhage. Acta neurochir 134, 55–59 (1995). https://doi.org/10.1007/BF01428504

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01428504

Keywords

Search

Navigation