[Experimental study on liquefaction of intracranial hematoma: usefulness of tissue-plasminogen activator (t-PA), a hematolytic agent, and its combination].
In stereotaxic aspiration of intracerebral hematoma and extensive removal, or cisternal drainage for subarachnoid hematoma, rapid and safe liquefaction and removal of clots are important and urgent measures to be taken. We performed a pharmacological experimental study on the efficacy, administration method, and toxicity of various hematolytic agents, especially tissue-Plasminogen Activator (t-PA). The following findings were obtained. 1) The amount, hardness, and histological findings concerning the remaining hematoma differed markedly according to which hematolytic agents were used. 2) The local effects of each hematolytic agent continued for about 4-8 hours but markedly decreased thereafter. 3) The hematolysis rate following single administration (6 hours after the blood collection) was 88.9% with t-PA + Elase (Fibrinolysin + Deoxyribonuclease), 85.4% with t-PA, 84.6% with t-PA + Urokinase, 80.2% with t-PA + Urokinase + Elase, 27.55 with Elase + Urokinase, 24.6% with Elase + Urokinase + Heparin, 17.2% with Heparin + Urokinase, 16.4% with Urokinase, 13.2% with Elase + Heparin, 12.6% with Elase, 9.3% with Heparin, and 10.1% with the control (Saline). Locally administered t-PA had remarkably greater hematolytic effects than Urokinase on the hematoma (p less than 0.001). 4) The hematolysis rate after 24 hours of repeated administration of small doses at 8-hour intervals was 100% with t-PA + Urokinase + Elase, 94.2% with t-PA, 93.8% with t-PA + Urokinase, 50.9% with Elase + Urokinase, 46.6% with Elase + Urokinase + Heparin, 33.7% with Urokinase, and 4.8% with the control.(ABSTRACT TRUNCATED AT 250 WORDS)
Ebina
K
K
Department of Neurosurgery, Hirosaki University School of Medicine, Aomori, Japan.
Okabe
S
S
Manabe
H
H
Iwabuchi
T
T
D000818:Animals; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000473:pathology; D004285:Dogs; D004359:Drug Therapy, Combination; D006406:Hematoma / Q000188:drug therapy* / Q000473:pathology; D006493:Heparin / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000494:pharmacology*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D011994:Recombinant Proteins; D006493:Heparin; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator