Document Detail

Recombinant tissue plasminogen activator in the treatment of intraventricular hemorrhage secondary to periventricular arteriovenous malformation before surgery: case report.
MedLine Citation:
PMID:  12657195     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE AND IMPORTANCE: Intraventricular hemorrhage (IVH) is known to cause acute obstructive hydrocephalus, refractory elevated intracranial pressures (ICPs), and lowered cerebral perfusion pressures, leading to cortical ischemia. Frequent obstruction of external ventricular drains as a result of thrombus is a recurring theme. We present a case of IVH secondary to periventricular arteriovenous malformation (AVM) that was not visible at admission angiography and was treated by intraventricular infusion of recombinant tissue plasminogen activator before surgical intervention. CLINICAL PRESENTATION: An 11-year-old boy presented with acute onset of headache followed by two seizures, loss of consciousness, decerebration, right temporal hematoma, IVH, and acute obstructive hydrocephalus. INTERVENTION: A right external ventricular drain was placed but functioned poorly. ICP could not be controlled by conventional methods. Five milligrams of recombinant tissue plasminogen activator was injected into the ventricular system via the external ventricular drain. This was repeated daily for 4 days. This treatment resulted in progressive improvement in ICP and clinical status. Once the clot partially cleared, magnetic resonance imaging and magnetic resonance angiography suggested the presence of a right periventricular arteriovenous malformation, which was confirmed by angiography and subsequently resected. CONCLUSION: Recombinant tissue plasminogen activator is effective in resolving IVH causing obstructive hydrocephalus and uncontrollable ICP posing a life-threatening situation, secondary to ruptured arteriovenous malformation, before surgical intervention.
Krishna Kumar; Denny D Demeria; Ashok Verma
Related Documents :
11879955 - Effects of transducer position on backscattered intensity in coronary arteries.
11426765 - Surgical experience with left ventricular free wall rupture.
16603695 - A novel strategy for increasing wall thickness of coronary venules prior to retroperfus...
1192855 - Echocardiographic manifestations of postinfarction ventricular septal rupture.
11545105 - Global alterations in mechanical function in healed reperfused first anterior myocardia...
17526985 - Difference in myocardial flow reserve between patients with dilated cardiomyopathy and ...
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  52     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-26     Completed Date:  2003-07-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  964-8; discussion 968-9     Citation Subset:  IM    
Department of Surgery, Section of Neurosurgery, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cerebral Angiography
Cerebral Hemorrhage / surgery*
Cerebral Ventricles / blood supply*
Hydrocephalus / drug therapy
Intracranial Arteriovenous Malformations / surgery*
Intracranial Pressure / drug effects
Magnetic Resonance Imaging
Recombinant Proteins / administration & dosage
Temporal Lobe / blood supply*
Thrombolytic Therapy*
Tissue Plasminogen Activator / administration & dosage*
Tomography, X-Ray Computed
Reg. No./Substance:
0/Recombinant Proteins; EC Plasminogen Activator

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

Previous Document:  Tension pneumocyst after transsphenoidal surgery for Rathke's cleft cyst: case report.
Next Document:  Transluminal balloon angioplasty improves brain tissue oxygenation and metabolism in severe vasospas...