Treatment of intraventricular hemorrhage with intraventricular administration of recombinant tissue plasminogen activator A clinical study of 18 cases.
OBJECTIVE
Intraventricular hemorrhage is associated with a very poor outcome. Simple external ventricular drainage alone has not resulted in a decline of mortality. The aim was to study the effect of direct intraventricular administration of recombinant tissue plasminogen activator (rtPA).


METHODS
A retrospective series of eighteen adult patients with severe intraventricular hemorrhage, admitted to our university hospital, was studied for the effect of direct intraventricular administration of recombinant tissue plasminogen activator (rtPA). rtPA was administered in a dosage of 2mg. The injection was repeated at 12h intervals until serial CT scans showed a substantial reduction of intraventricular blood.


RESULTS
The total of rtPA doses per patient ranged from 2 to 32mg. Seven out of 18 patients showed good neurological recovery, 4 died. Only one patient had a complication which could be directly attributed to the intraventricular thrombolytic therapy.


CONCLUSIONS
We conclude that the procedure of intraventricular administration of a thrombolytic agent, i.e. rtPA, seems effective in lysis of the intraventricular hematoma and may, therefore, improve outcome.
Vereecken
Kevin K
KK
Department of Critical Care Medicine, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem, Belgium.
Van Havenbergh
Tony
T
De Beuckelaar
Wim
W
Parizel
Paul M
PM
Jorens
Philippe G
PG
D000328:Adult; D000368:Aged; D002552:Cerebral Ventricles; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007839:Functional Laterality / Q000502:physiology; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000473:pathology*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014696:Ventriculostomy
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator