| Urokinase in the treatment of shunt malfunctions caused by thrombus. | |
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MedLine Citation:
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PMID: 9348152 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Thrombus is a frequent cause of shunt malfunction both of the proximal end following intraventricular hemorrhage and of the distal catheter of a vascular shunt. Continued blockages may result in numerous shunt revisions until the blood has been cleared. We have treated 3 children with shunt malfunctions secondary to thrombus with urokinase, a thrombolytic agent. Two children had intraventricular hemorrhage following a shunt revision and were treated with intrashunt urokinase, and 1 with occlusion of an atrial catheter was treated with both intrashunt and systemic urokinase. All were symptomatic at the time of treatment (headaches, vomiting, full fontanel, somnolence) and all had ventriculomegaly demonstrated on computed tomography. Various dosage regimens were used with total intrashunt doses of 20,000, 50,000, and 70,000 IU. All improved clinically, computed tomography scans demonstrated improvement, and all were discharged from the hospital. There were no complications of the urokinase administration. The 2 children with proximal occlusion have not required further shunt revisions at 12 and 27 months following treatment. The infant with atrial end occlusion subsequently underwent two proximal revisions with eventual removal of the atrial catheter because of infection. We conclude the intrashunt urokinase can be of value in the treatment of shunts by blood and blood products. |
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Authors:
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R J Hudgins; W R Boydston; C L Gilreath |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Pediatric neurosurgery Volume: 25 ISSN: 1016-2291 ISO Abbreviation: Pediatr Neurosurg Publication Date: 1996 Dec |
Date Detail:
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Created Date: 1997-12-10 Completed Date: 1997-12-10 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9114967 Medline TA: Pediatr Neurosurg Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 315-20 Citation Subset: IM |
Affiliation:
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Department of Pediatric Neurosurgery, Scottish Rite Children's Medical Center, Atlanta, Ga., USA. rogerhud@aol.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cerebrospinal Fluid Shunts
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instrumentation* Child Child, Preschool Dose-Response Relationship, Drug Equipment Failure Fibrinolytic Agents / administration & dosage* Humans Hydrocephalus / radiography, surgery Infant Infusions, Intravenous Intracranial Embolism and Thrombosis / drug therapy*, radiography Male Postoperative Complications / drug therapy*, radiography Tomography, X-Ray Computed Urokinase-Type Plasminogen Activator / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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