Neurosurgical Review

, Volume 18, Issue 2, pp 95–100 | Cite as

Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase

  • Hidayet Akdemir
  • Ahmet Selçuklu
  • Aydin Paşaoğlu
  • I Suat Öktem
  • Ikram Kavuncu
Original Articles

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.

Keywords

Intraventricular hemorrhage urokinase ventricular drainage 

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References

  1. [1]
    Akdemir H, A Paşaoğlu, TE Patiroğlu: Lizis of intracranial hematomas with urokinase. Erciyes Med J 10 (1988) 199–208Google Scholar
  2. [2]
    Akdemir H, A Paşaoğlu, A Selçuklu et al: Local aspiration of primary intracerebral hematomas with urokinase. Dğa-TR J of Medical Sciences 16 (1992) 411–418Google Scholar
  3. [3]
    Doi E, H Moriwaki, N Komai et al: Sterotactic evacuation of intracerebral hematomas. Neurol Med Chir 22 (1982) 461–467Google Scholar
  4. [4]
    Graeb DA, WD Robertson, JS Lapointe et al: Computed Tomographic diagnosis of intraventricular hemorrhage: Etiology and prognosis. Radiology 143 (1982) 91–96Google Scholar
  5. [5]
    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) 822–828Google Scholar
  6. [6]
    Jennett B, H Bond: Assessment of outcome after severe brain damage. Lancet 1 (1975) 480–484Google Scholar
  7. [7]
    Kim CH, R Tanaka, K Kawakami et al: Traumatic primary intraventricular hemorrhage. Surg Neurol 16 (1981) 415–417Google Scholar
  8. [8]
    Little JR, GA Blomquist Jr, R Ethier: Intraventricular hemorrhage in adults. Surg Neurol 8 (1977) 143–149Google Scholar
  9. [9]
    Matsumoto K, C Honda: CT-guided sterotactic evacuation of hypertensive intracerebral hematomas. J Neurosurg 61 (1984) 440–448Google Scholar
  10. [10]
    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) 217–222Google Scholar
  11. [11]
    Narayan RK, TM Narayan, DA Kaltz et al: Lysis of intracranial hematomas with urokinase in a rabbit model. J Neurosurg 62 (1985) 580–586Google Scholar
  12. [12]
    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) 427–430Google Scholar
  13. [13]
    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) 553–571Google Scholar
  14. [14]
    Ruscalleda J, A Peiro: Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage. Neuroradiology 28 (1986) 34–37Google Scholar
  15. [15]
    Teasdale G, B Jennett: Assessment of coma and impaired consciousness: a practical scale. Lancet 2 (1974) 81–84Google Scholar
  16. [16]
    Todo T, M Usui, K Takakura: Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. J Neurosurg 74 (1991) 81–86Google Scholar
  17. [17]
    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) 45–48Google Scholar
  18. [18]
    Yamamoto Y, S Waga: Persistent intraventricular hematoma following ruptured aneurysm. Surg Neurol 17 (1982) 301–303Google Scholar

Copyright information

© Walter de Gruyter & Co 1995

Authors and Affiliations

  • Hidayet Akdemir
    • 1
  • Ahmet Selçuklu
    • 1
  • Aydin Paşaoğlu
    • 1
  • I Suat Öktem
    • 1
  • Ikram Kavuncu
    • 1
  1. 1.Department of NeurosurgeryErciyes University, School of MedicineKayseriTurkey

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