Cohort study of intraventricular thrombolysis with recombinant tissue plasminogen activator for aneurysmal intraventricular hemorrhage

Neurosurgery
J Max Findlay, Michael J Jacka

Abstract

Thrombolytic agents have been administered through external ventricular drains to treat intraventricular hemorrhage, the goals being to accelerate clot clearance, prevent catheter obstruction, and help control intracranial pressure. We compared these variables in a group of aneurysm patients treated by one surgeon who routinely used intraventricular recombinant tissue plasminogen activator (rt-PA) for obstructive hematocephalus with those in a group of similar patients treated by other surgeons who did not. Patients included in this analysis were those with repaired cerebral aneurysms causing hemorrhage into at least three ventricles with ventriculomegaly requiring external ventricular drainage. The ventricular system was considered "opened" when all ventricles were patent and reduced in size on computed tomographic scans. Those treated with rt-PA received 4 mg/d through a ventricular drain until ventricular opening. The mean number of days to ventricular opening was 3.9 (standard deviation [SD], 1.0) for the 21 patients treated with rt-PA and 7.1 (SD, 3.7) for the 9 who were not (P = 0.001), and the mean intracranial pressure (mm Hg) 24 hours after treatment with rt-PA was 10.4 (SD, 6.1) compared with 14.1 (SD, 5.9) during the...Continue Reading

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Citations

Jun 27, 2012·Neurosurgical Review·Thomas GaberelEvelyne Emery
Apr 29, 2010·Current Neurology and Neuroscience Reports·Holly E HinsonWendy C Ziai
Jan 12, 2011·Current Treatment Options in Neurology·Joshua N Goldstein, Aaron J Gilson
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Apr 9, 2015·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Andreas H KramerJohn H Wong
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Aug 6, 2011·Stroke; a Journal of Cerebral Circulation·Thomas GaberelEvelyne Emery
Aug 4, 2019·Neurocritical Care·Thomas S van SolingeOmar Arnaout

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