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Management of Intraventricular Hemorrhage

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Abstract

Brain hemorrhage is the most fatal form of stroke and has the highest morbidity of any stroke subtype. Intraventricular extension of hemorrhage (IVH) is a particularly poor prognostic sign, with expected mortality between 50% and 80%. IVH is a significant and independent contributor to morbidity and mortality, yet therapy directed at ameliorating intraventricular clot has been limited. Conventional therapy centers on managing hypertension and intracranial pressure while correcting coagulopathy and avoiding complications such as rebleeding and hydrocephalus. Surgical therapy alone has not changed the natural history of the disease significantly. However, fibrinolysis in combination with extraventricular drainage shows promise as a technique to reduce intraventricular clot volume and to manage the concomitant complications of IVH.

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Disclosure

Dr. Hanley and Dr. Ziai are investigators in the CLEAR-IVH trial, which is sponsored by the US Food and Drug Administration’s orphan drug program and assisted by a donation from Cathflo and a sponsored research agreement from Genentech (use patent: Johns Hopkins medical institutions). No other potential conflicts of interest relevant to this article were reported.

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  1. Neurosciences Critical Care Division, The Johns Hopkins University School of Medicine, Meyer 8-140, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Holly E. Hinson, Daniel F. Hanley & Wendy C. Ziai

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  1. Holly E. Hinson
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Correspondence to Daniel F. Hanley.

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Hinson, H.E., Hanley, D.F. & Ziai, W.C. Management of Intraventricular Hemorrhage. Curr Neurol Neurosci Rep 10, 73–82 (2010). https://doi.org/10.1007/s11910-010-0086-6

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