title: Stereotactically guided thrombolysis of deep cerebral hemorrhage: preliminary results.
abstract: BACKGROUND
  The neurologic outcome from conventional medical or surgical therapy of intracerebral hemorrhage (ICH) is poor; however, stereotactically guided instillation of thrombolytic agents to dissolve parenchymal clots due to hypertensive hemorrhage has recently produced results equal to or better than those obtained with conventional therapies.
  
  
  OBJECTIVE
  To determine whether stereotactic thrombolysis of deep ICH is safe and effective.
  
  
  METHODS
  We administered urokinase to clots in four patients with hypertensive ICH. After the hemorrhage was localized using angiography and computed tomography-assisted stereotactic technique, a ventricular catheter was used to administer urokinase to the clot.
  
  
  RESULTS
  Preliminary results showed dramatic reduction in clot volume within 48 hours of initiating treatment and modest clinical improvement in all four patients. No further hemorrhages were seen after treatment. Three patients ultimately died of non-neurologic causes.
  
  
  CONCLUSIONS
  With careful patient selection, stereotaxy-assisted thrombolytic therapy may be an advance in the treatment of certain cases of ICH.
authors.affiliation: Department of Neurological Surgery, Cleveland Clinic Foundation, OH 44195.
authors.forename: D W
authors.initials: DW
authors.lastname: Miller
authors.forename: G H
authors.initials: GH
authors.lastname: Barnett
authors.forename: D W
authors.initials: DW
authors.lastname: Kormos
authors.forename: C P
authors.initials: CP
authors.lastname: Steiner
mesh_terms: D000368:Aged; D002404:Catheterization; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D013238:Stereotaxic Techniques; D013396:Suction; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014568:Urokinase-Type Plasminogen Activator