Lower dose intraventricular T-PA fibrinolysis: case report.
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.
Deutsch
Harel
H
Department of Neurosurgery, Chicago Institute of Neurosurgery and Neuroresearch, Chicago, Illinois, USA.
Rodriguez
John Carlos
JC
Titton
Ross L
RL
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
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator