title: Lower dose intraventricular T-PA fibrinolysis: case report.
abstract: BACKGROUND
  Recombinant tissue plasminogen activator (rtPA) intraventricular fibrinolysis has been demonstrated to be efficacious in clearing blood from the ventricular system. Preliminary studies indicate it may improve survival. There have also been reports of adverse affects from intraventricular fibrinolysis. Optimal dosing of rtPA has not been established.
  
  
  METHODS
  A 40-year-old patient with intraventricular hemorrhage extension secondary to a ruptured aneurysm was treated with a one-time infusion of 1 mg of rtPA through a right ventriculostomy.
  
  
  RESULTS
  Computed tomography scans demonstrated excellent resolution of intraventricular blood and improvement in cerebral spinal fluid flow after fibrinolysis. Fibrinolysis was most marked in the third and fourth ventricles. There were no adverse effects noted.
  
  
  CONCLUSIONS
  Intraventricular fibrinolysis is effective at a lower dose than previously used. Lower doses may have fewer adverse affects.
authors.affiliation: Department of Neurosurgery, Chicago Institute of Neurosurgery and Neuroresearch, Chicago, Illinois, USA.
authors.forename: Harel
authors.initials: H
authors.lastname: Deutsch
authors.forename: John Carlos
authors.initials: JC
authors.lastname: Rodriguez
authors.forename: Ross L
authors.initials: RL
authors.lastname: Titton
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007276:Injections, Intraventricular; D002532:Intracranial Aneurysm / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014696:Ventriculostomy / Q000379:methods
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator