Treatment of intraventricular hemorrhage with urokinase : effects on 30-Day survival
N J Naff1, J R Carhuapoma, M A Williams
1Division of Neurosurgery, Walter Reed Army Medical Center, Washington DC, USA.
Background And Purpose:
Intraventricular hemorrhage (IVH) remains associated with high morbidity and mortality. Therapy with external ventricular drainage alone has not modified outcome in these patients.
Methods:
Twelve pilot IVH patients who required external ventricular drainage were prospectively treated with intraventricular urokinase followed by the randomized, double-blinded allocation of 8 patients to either treatment or placebo. Observed 30-day mortality was compared with predicted 30-day mortality obtained by use of a previously validated method.
Results:
Twenty patients were enrolled; admission Glasgow Coma Scale score in 11 patients was
Conclusions:
Intraventricular urokinase may significantly improve 30-day survival in IVH patients. On the basis of current evidence, a double-blinded, placebo-controlled, multicenter study that uses thrombolysis to treat IVH has received funding and began January 1, 2000.
