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Inflammatory response to intraventricular hemorrhage: Time course, magnitude and effect of t-PA.
MedLine Citation:
PMID:  22126859     Owner:  NLM     Status:  Publisher    
BACKGROUND: In 45% of cases of intracerebral hemorrhage (ICH) the hematoma extends into the ventricles (IVH). Intraventricular inflammation may be one mechanism by which IVH exerts deleterious effects. Tissue plasminogen activator instillation into the ventricles (IVT) has been studied for the treatment of IVH; however, its effect on IVH-induced inflammation is unknown. The purpose of this work was to describe the inflammatory response in the CSF following IVH and compare it in patients treated or not treated with IVT. METHODS: Consecutive patients diagnosed with IVH and treated with ventriculostomy were selected from our prospective stroke registry from November 2004 to July 2007. CSF protein, glucose, and WBC (corrected for RBC number) from samples collected up to 19days after IVH were captured. Patients with evidence of CSF infection were excluded. RESULTS: 29 patients were identified: 18 in the IVT group and 11 in the non-IVT group. The two groups were comparable in terms of stroke severity and IVH volume. A brisk cellular inflammatory reaction developed around day 2, lasted 5days and then subsided. IVT seemed to attenuate this response. There were no differences in clinical outcomes between groups. CONCLUSIONS: IVH induces intrathecal inflammatory response that peaks at day 5. IVT appears to modify this inflammation. Further work is needed to study the relationship between the intraventricular inflammatory response and patient outcome.
Hen Hallevi; Kyle C Walker; Mallikarjunarao Kasam; Natan Bornstein; James C Grotta; Sean I Savitz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-27
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  -     ISSN:  1878-5883     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Neurology Department and Stroke Unit, Tel-Aviv Sourasky Medical Center and Tel-Aviv University, Israel.
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