title: A randomized, placebo-controlled pilot study of patients with spontaneous intraventricular haemorrhage treated with intraventricular thrombolysis.
abstract: Intraventricular hemorrhage (IVH) occurring after spontaneous intracerebral hemorrhage (ICH) is an independent risk factor for mortality. The use of intraventricular urokinase (Uk) to reduce intraventricular blood clot volume and improve outcome was investigated. Patients with IVH requiring external ventricular drainage were recruited and randomized into a double-blind placebo controlled study. Assessments of collected cerebrospinal fluid (CSF) haemoglobin (Hb) and serial CT scans were performed. The study outcomes were: infection rates, length of stay in the intensive care unit, survival, National Institutes of Health Stroke Scale score; and modified Rankin Scale scores. Our results showed an increase in both the drained CSF Hb concentration in patients treated with Uk compared to placebo and in the rate of resolution clot volume. No differences were found in the other outcome measures but there was a trend towards lowered mortality in the group treated with Uk. Therefore, intraventricular Uk resulted in faster resolution of IVH with no adverse events.
authors.affiliation: Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. nicolas_kon@nni.com.sg
authors.forename: Nicolas K K
authors.initials: NK
authors.lastname: King
authors.forename: Jin Li
authors.initials: JL
authors.lastname: Lai
authors.forename: Li Bing
authors.initials: LB
authors.lastname: Tan
authors.forename: Kah Keow
authors.initials: KK
authors.lastname: Lee
authors.forename: Boon Chuan
authors.initials: BC
authors.lastname: Pang
authors.forename: Ivan
authors.initials: I
authors.lastname: Ng
authors.forename: Ernest
authors.initials: E
authors.lastname: Wang
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002543:Cerebral Hemorrhage / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006454:Hemoglobins / Q000134:cerebrospinal fluid; D006801:Humans; D007276:Injections, Intraventricular; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D006454:Hemoglobins; D014568:Urokinase-Type Plasminogen Activator