Document Detail

Outcome analysis of intraventricular thrombolytic therapy for intraventricular haemorrhage.
MedLine Citation:
PMID:  14530527     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate the outcome of intraventricular thrombolytic therapy for intraventricular haemorrhage and to formulate a safe and effective regimen. DESIGN: Retrospective study. SETTING: Regional neurosurgical centre, Hong Kong. PATIENTS: Twenty-nine consecutive adult patients who presented from November 1995 to November 1998 with non-traumatic intraventricular haemorrhage (Graeb score, > or =7) with no active rebleeding risks from vascular abnormalities. INTERVENTIONS: Fourteen consecutive patients received intraventricular streptokinase via the external ventricular drainage, and 15 consecutive patients received intraventricular urokinase treatment. MAIN OUTCOME MEASURES: Patient demographics, Glasgow coma scale score, Graeb score, mortality rate, shunt rate, fever response, infection rate, catheter blockage rate, and local and systemic bleeding tendency. RESULT: The mean age of the 16 men and 13 women was 59 years (range, 14-76 years). The median Graeb score for cases of intraventricular haemorrhage was 10 (range, 7-12). There was no significant difference in terms of the Graeb score distribution, total dosage, and duration of treatment between the streptokinase and urokinase groups. More cases of fever were observed in the streptokinase group, which could be due to its antigenicity. The infection rate of the central nervous system was 3%, and the shunt rate was 24%. The overall 1-month postoperative mortality was 10%, which was related to a low preoperative Glasgow coma scale score (< or =4). No local rebleeding, systemic coagulopathy, or catheter blockage occurred. CONCLUSIONS: Intraventricular thrombolytic therapy is a safe and effective method of managing intraventricular haemorrhage. We suggest instilling 20 000 units urokinase intra-operatively, followed by 20 000 units daily for about 3 days, except in cases of vascular abnormality, bleeding tendency, and trauma.
M W Y Lee; K Y Pang; W W S Ho; C K Wong
Related Documents :
3540097 - The treatment of refractory ascites by the leveen shunt. a multi-centre controlled tria...
9205167 - Bidirectional cavopulmonary shunt in patients with anomalies of systemic and pulmonary ...
10804727 - Echocardiographic evaluation of the ductal morphology in patients with refractoriness t...
14500067 - Follow-up after surgical closure of congenital ventricular septal defect.
21906457 - Preventive efficacy of ondansetron and granisetron for postoperative nausea and vomitin...
9794047 - Anterior discectomy and fusion for painful cervical disc disease. a report of 50 patien...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine     Volume:  9     ISSN:  1024-2708     ISO Abbreviation:  Hong Kong Med J     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-07     Completed Date:  2004-06-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9512509     Medline TA:  Hong Kong Med J     Country:  China    
Other Details:
Languages:  eng     Pagination:  335-40     Citation Subset:  IM    
Department of Neurosurgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, ROC.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cerebral Hemorrhage / therapy*
Cerebral Ventricles
Fever / etiology
Injections, Intraventricular
Middle Aged
Plasminogen Activators / therapeutic use*
Retrospective Studies
Streptokinase / therapeutic use*
Thrombolytic Therapy*
Treatment Outcome
Urokinase-Type Plasminogen Activator / therapeutic use*
Reg. No./Substance:
EC 3.4.-/Streptokinase; EC 3.4.21.-/Plasminogen Activators; EC Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Large-scale mercury exposure due to a cream cosmetic: community-wide case series.
Next Document:  Prognostic factors for successful outcome in patients undergoing controlled ovarian stimulation and ...