The Results of Extraventricular Drainage Combined with Intraventricular Injection of Urokinase for Intraventricular Hematomas

ABSTRACT

The authors applied extraventricular drainage combined with intermittent intraventricular injection of urokinase to 21 patients with intraventricular hemtoma and ventricular dilatation. Ten-thousand IU of urokinase was injected every 12 hours for 3 days. Follow-up CT on day 4 after the treatment showed complete disappearance of the hematoma in the 3rd and 4th ventricles and a small residual hematoma in the occipital horns of lateral ventricles in the majority(14 patients) of the patients. Obstruction of the drainage catheter did not occur in any case, but transient pleocytosis in CSF study, ventriculitis, and rebleeding complicated 6,4, and 4 cases, respectively. The duration of extraventricular drainage in the 17 patients without major complications was 3-17 days. The clinical and death in 7 cases. The decisive events that were thought to have caused vegetative states or death in the 13 case. The method of extraventricular drainage combined with intermittent intraventricular injection of urokinase seems useful in revoving intraventricular hematomas, futher investigation including prospective studies is necessary to determine whether the intraventricular injection of urokinase significantly improves the final outcomes of those patients with severe intraventricular hematomas.