Acta Neurochirurgica

, Volume 160, Issue 5, pp 1073–1077 | Cite as

Intraventricular urokinase to treat a blocked ventriculoperitoneal shunt in a glioblastoma patient with leptomeningeal spread

  • Peter Y. M. Woo
  • James T. F. Zhuang
  • Jason M. K. Ho
  • Andrew Seto
  • Hoi-Tung Wong
  • Kwong-Yau Chan
Case Report - Brain Tumors
Part of the following topical collections:
  1. Brain tumors


Leptomeningeal spread and hydrocephalus are increasingly recognized as late disease complications of glioblastoma with almost a quarter of patients requiring early cerebrospinal fluid shunting. The neurosurgeon is challenged with maintaining shunt patency when tumor disease progression is rapid and adjuvant oncologic therapy has yet to be initiated. We describe our experience in treating a young female with diffuse glioblastoma leptomeningeal spread and communicating hydrocephalus who had several episodes of shunt obstruction due to intraluminal tumor cell-fibrin deposits. Regular intraventricular instillations of urokinase fibrinolytic therapy not only re-established shunt patency but also contributed to the resolution of her hydrocephalus.


Glioblastoma Leptomeningeal spread Hydrocephalus Fibrinolytic Urokinase 



This manuscript is dedicated to the patient CMY and was supported by the Tung Wah Group of Hospitals Clinical Research Center.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from the individual participant included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryKwong Wah HospitalYaumateiHong Kong

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