title: Treatment of a recurrent subdural hematoma using urokinase.
abstract: Previous reports describe the intraventricular, subarachnoid, and intraparenchymal use of thrombolytic agents. However, the use of thrombolytic agents in the management of extraaxial hematomas has not been described. Following the evacuation of a subacute subdural hematoma, this 48-year-old woman experienced declining neurologic function due to the reaccumulation of blood in the subdural space. Urokinase was administered via a subdural drain. The patient experienced rapid clinical improvement and radiographic resolution of the recrudescent subdural hematoma. If repeat surgical evacuation of a subdural hematoma is not possible, urokinase may be instilled into the subdural space to enhance drainage of a subdural hematoma.
authors.affiliation: Department of Neurosurgery, Mount Sinai Medical Center, New York, New York, USA. arginteanu@yahoo.com
authors.forename: M S
authors.initials: MS
authors.lastname: Arginteanu
authors.forename: H
authors.initials: H
authors.lastname: Byun
authors.forename: W
authors.initials: W
authors.lastname: King
mesh_terms: D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator