Thrombolytics in intraventricular hemorrhage
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Intraventricular hemorrhage (IVH) may occur as an isolated event from primary ventricular bleeding or as a complication of brain hemorrhage from another etiology. It is associated with high mortality and morbidity. Recent translational and clinical studies demonstrate that thrombolytic drugs administered intraventricularly through an external ventricular drain to lyse an IVH clot are safe and may reduce morbidity and mortality. The ongoing, prospective, randomized clinical trial known as Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage (CLEAR IVH) offers new hope for patients with this devastating disease. Preliminary data show marked reduction in time to clot lysis as well as a potential reduction in mortality associated with IVH lysis. A large, phase III, randomized prospective trial to ascertain the true clinical efficacy of this treatment is currently in the planning stages. A review of the use of thrombolytics for treatment of IVH related to other secondary causes is also provided.
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References and Recommended Reading
- 5.Adams HP, Torner JC, Kassell NF: Intraventricular hemorrhage among patients with recently ruptured aneurysms: a report of the Cooperative Aneurysm Study. Stroke 1992, 23:140.Google Scholar
- 20.Bagley C: Blood in cerebrospinal fluid. Resultant functional and organic alterations in the cent ral nervous system. Arch Surg 1928, 17:39–81.Google Scholar
- 25.Mendelow AD, Gregson BA, Fernandes HM, et al.; STICH investigators: Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet 2005, 365:387–397.PubMedGoogle Scholar
- 33.Fountas KN, Kapasalaki EZ, Parish DC, et al.: Intraventricular administration of rt-PA in patients with intraventricular hemorrhage. South Med J 2005, 8:760.Google Scholar
- 34.Lapointe M, Haines S: Fibrinolytic therapy for intraventricular hemorrhage in adults. Cochrane Database Syst Rev 2002, 3:CD003692.Google Scholar
- 40.Whitelaw A: Intraventricular streptokinase after intraventricular hemorrhage in newborn infants. Cochrane Database Syst Rev 2001, 1.Google Scholar