title: Thrombolytics in intraventricular hemorrhage.
abstract: Intraventricular hemorrhage (IVH) may occur as an isolated event from primary ventricular bleeding or as a complication of brain hemorrhage from another etiology. It is associated with high mortality and morbidity. Recent translational and clinical studies demonstrate that thrombolytic drugs administered intraventricularly through an external ventricular drain to lyse an IVH clot are safe and may reduce morbidity and mortality. The ongoing, prospective, randomized clinical trial known as Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage (CLEAR IVH) offers new hope for patients with this devastating disease. Preliminary data show marked reduction in time to clot lysis as well as a potential reduction in mortality associated with IVH lysis. A large, phase III, randomized prospective trial to ascertain the true clinical efficacy of this treatment is currently in the planning stages. A review of the use of thrombolytics for treatment of IVH related to other secondary causes is also provided.
authors.affiliation: Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 8-138, Baltimore, MD 21287-7840, USA. pnyquis1@jhmi.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Nyquist
authors.forename: Shannon
authors.initials: S
authors.lastname: LeDroux
authors.forename: Romergryko
authors.initials: R
authors.lastname: Geocadin
mesh_terms: D000818:Animals; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D005343:Fibrinolytic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D020767:Intracranial Thrombosis / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D023421:Models, Animal; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents