Stereotactic fibrinolysis of spontaneous intracerebral hematoma using infusion of recombinant tissue plasminogen activator.
OBJECTIVE
The authors present a prospective study on 10 patients with stereotactic infusion of tissue plasminogen activator (rtPA) intraparenchimal hemorrhage.


METHODS
Between 1999 and 2000, 10 patients with deep seated hematomas in the basal ganglia were selected for stereotactic infusion of rtPA and spontaneous clot drainage.


RESULTS
All cases had about 80% reduction of the hematoma volume in the CT scan at the third day. The intracranial pressure was normalized by the third day too. There were no local or systemic complications with the use of this thrombolytic. The results were shown by the Glasgow Outcome Scale with six patients in V, three in IV and one in III after 3 months.


CONCLUSIONS
Early treatment and drainage with minimally invasive neurosurgery, can make these patients with deep-seated hematomas recover the consciousness and they can be rehabilitated earlier avoiding secondary complications.
Departamento de Neurocirurgia, Centro de Investigação Neurológica, Instituto do Sono Estácio de Sá, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brasil. nasser@riodejaneiro.net
José Augusto
JA
Nasser
Asdrubal
A
Falavigna
Márcio
M
Bezerra
Victor
V
Martinez
Gabriel
G
Freitas
Armando
A
Alaminos
Antônio
A
Bonatelli
Fernando
F
Ferraz
D000368:Aged; D020145:Basal Ganglia Hemorrhage / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D015600:Glasgow Coma Scale; D006406:Hematoma / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D020299:Intracranial Hemorrhage, Hypertensive / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D013238:Stereotaxic Techniques; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator