ADVANCES IN THE TREATMENT OF ADULT INTRAVENTRICULAR HEMORRHAGE

Michael L. Rolli; Neal J. Naff

doi:10.1055/s-2000-11555

Seminars in Neurosurgery, Inhaltsverzeichnis

Seminars in Neurosurgery 2000; 11(1): 27-40
DOI: 10.1055/s-2000-11555

ADVANCES IN THE TREATMENT OF ADULT INTRAVENTRICULAR HEMORRHAGE

Michael L. Rolli¹ , Neal J. Naff²

¹Department of Surgery, Walter Reed Army Medical Center, Washington, District of Columbia;
²Division of Neurosurgery, Walter Reed Army Medical Center, Washington, District of Columbia; National Naval Medical Center, Bethesda, Maryland; Uniformed Services University of the Health Sciences, Bethesda, Maryland; Johns Hopkins University School of Medicine, Baltimore, Maryland

Abstract

ABSTRACT

Intraventricular hemorrhage (IVH) is a frequent complication of intracranial hemorrhage and severe head trauma. Recent research suggests that IVH is a significant and independent contributor to morbidity and mortality in these conditions. Despite the contribution of IVH to poor outcome there has been little clinical research directed at improving the treatment of IVH. Indeed, until recently little effort has been made to directly treat IVH. Rather, most of the management of IVH has been directed at the treatment of its complications: obstructive and communicating hydrocephalus. Intraventricular thrombolysis has emerged as a promising new intervention that directly attacks the IVH itself. This review will discuss the etiology, presentation, and pathophysiology of IVH. The conventional management of IVH and its deficiencies will be discussed. The rationale for and the early clinical experience with intraventricular thrombolysis will be reviewed. Recommendations regarding the practical application of intraventricular thrombolysis will be offered.

KEYWORD

Intraventricular hemorrhage - thrombolysis - intracerebral hemorrhage

Volltext

Referenzen

REFERENCES

1 Daverat P, Castel J P, Dartigues J F, Orgogozo J M. Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis. Stroke . 1991; 22 1-6
2 Adams Jr P H. Prevention of brain ischemia after aneurysmal subarachnoid hemorrhage. Neurol Clin . 1992; 10 251-268
3 Broderick J P, Brott T G, Duldner J E, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke . 1993; 24 987-993
4 Lisk D R, Pasteur W, Rhoades H, Putnam R D, Grotta J C. Early presentation of hemispheric intracerebral hemorrhage: Prediction of outcome and guidelines for treatment allocation. Neurology . 1994; 44 133-139
5 Young W B, Lee K P, Pessin M S, Kwan E S, Rand W M, Caplan L R. Prognostic significance of ventricular blood in supratentorial hemorrhage: A volumetric study. Neurology . 1990; 40 616-619
6 Tuhrim S, Dambrosia J M, Price T R. Intracerebral hemorrhage: External validation and extension of a model for prediction of 30-day survival. Ann Neurol . 1991; 29 658-663
7 Tuhrim S, Horowitz D R, Sacher M, Godbold J H. Validation and comparison of models predicting survival following intracerebral hemorrhage. Crit Care Med . 1995; 23 950-954
8 Findlay J M, Wong J H. Clinical aspects of intraventricular hemorrhage. In: Welch KMA, Caplan LR, Reis DJ, eds. Primer on Cerebrovascular Diseases San Diego, CA: Academic Press 1997: 437-446
9 Cordobes F, de la Fuente M, Lobato R D. Intraventricular hemorrhage in severe head injury. J Neurosurg . 1983; 58 217-222
10 Fujitsu K, Kuwabara T, Muramoto M, Hirata K, Mochimatsu Y. Traumatic intraventricular hemorrhage: Report of twenty-six cases and consideration of the pathogenic mechanism. Neurosurgery . 1988; 23 423-430
11 Tsai F Y, Huprich J E, Gardner F C, Segall H D, Teal J S. Diagnostic and prognostic implications of computed tomography of head trauma. J Comput Assist Tomogr . 1978; 2 323-331
12 Zuccarello M, Iavicoli R, Pardatscher K. Posttraumatic intraventricular haemorrhages. Acta Neurochir . 1981; 55 283-293
13 LeRoux P D, Haglund M M, Newell D W, Grady M S, Winn H R. Intraventricular hemorrhage in blunt head trauma: An analysis of 43 cases. Neurosurgery . 1992; 31 678-684
14 Levin H S, Williams D, Crofford M J. Relationship of depth of brain lesions to consciousness and outcome after closed head injury. J Neurosurg . 1988; 69 861-866
15 Ruscalleda J, Peiro A. Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage. Neuroradiology . 1986; 28 34-37
16 Little J R, Blomquist Jr A G, Ethier R. Intraventricular hemorrhage in adults. Surg Neurol . 1977; 8 143-149
17 DeLand F H, James Jr E A, Ladd D J, Konigsmark B W. Normal pressure hydrocephalus: A histologic study. Am J Clin Pathol . 1972; 58 58-63
18 Graeb D A, Robertson W D, Lapointe J S, Nugent R A, Harrison P B. Computed tomographic diagnosis of intraventricular hemorrhage. Etiology and prognosis. Radiology . 1982; 143 91-96
19 Ellington E, Margolis G. Block of arachnoid villus by subarachnoid hemorrhage. J Neurosurg . 1969; 30 651-657
20 Bagley C. Blood in the cerebrospinal fluid. Resultant functional and organic alterations in the central nervous system. Arch Surg . 1928; 17 39-81
21 Kibler R, Couch R, Crompton M. Hydrocephalus in the adult following spontaneous hemorrhage. Brain . 1961; 84 45-61
22 Portenoy R K, Lipton R B, Berger A R, Lesser M L, Lantos G. Intracerebral haemorrhage: A model for the prediction of outcome. J Neurol Neurosurg Psychiatry . 1987; 50 976-979
23 Mohr G, Ferguson G, Khan M. Intraventricular hemorrhage from ruptured aneurysm. Retrospective analysis of 91 cases. J Neurosurg . 1983; 58 482-487
24 Papile L A, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gm. J Pediatr . 1978; 92 529-534
25 Ahmann P, Lazzarra A, Dykes F. Intraventricular hemorrhage in the high risk preterm infant: Incidence and outcome. Ann Neurol . 1980; 7 118-124
26 Fisher C, Kistler J, Davis J. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery . 1980; 6 1-9
27 Yasargil M, Yonekawa Y, Zumstein B. Hydrocephalus following spontaneous subarachnoid hemorrhage. Clinical features and treatment. J Neurosurg . 1973; 39 474-479
28 Kassell N F, Torner J C, Adams Jr P H. Antifibrinolytic therapy in the acute period following aneurysmal subarachnoid hemorrhage. Preliminary observations from the Cooperative Aneurysm Study. J Neurosurg . 1984; 61 225-230
29 Sasaki T,Wakai S, Asano T, Watanabe T, Kirino T, Sano K. The effect of a lipid hydroperoxide of arachidonic acid on the canine basilar a. An experimental study on cerebral vasospasm. J Neurosurg . 1981; 54 357-365
30 Osaka K. Prolonged vasospasm produced by the breakdown of erythrocytes. J Neurosurg . 1977; 47 403-411
31 Handa Y, Weir B, Nosko M. The effect of timing of clot removal on chronic vasospasm in a primate model. J Neurosurg . 1987; 67 558-564
32 Peterson E, Choo S, Lewis A. Lysis of blood clot and experimental treatment of subarachnoid hemorrhage. Baltimore, MD: Williams & Wilkins; 1980
33 Messina A, Chernik N. The ``resolving'' intracerebral hemorrhage. Radiology . 1976; 118 609-613
34 New P, Aronow S. Attenuation measurements of whole blood and blood fractions in computed tomography. Radiology . 1976; 121 635-640
35 Bergstrom M, Ericson K, Levander B. Variation with time of the attenuation values of intracranial hematomas. J Comput Assist Tomography . 1977; 1 57-63
36 Scott W, New P, Davis K. Computerized axial tomography of intracerebral and intraventricular hemorrhage. Radiology . 1974; 112 73-80
37 Naff N J, Bryan R N, Rigamonti D R, Hanley D F. Blood clot resolution in human CSF: A serial quantitative study. Abstract. Joint Section on Cerebrovascular Surgery Annual Meeting. Anaheim, CA 1997
38 Aucoin P J, Kotilainen H R, Gantz N M, Davidson R, Kellogg P, Stone B. Intracranial pressure monitors. Epidemiologic study of risk factors and infections. Am J Med . 1986; 80 369-376
39 Rosner M J, Becker D P. ICP monitoring: Complications and associated factors. Clin Neurosurg . 1976; 23 494-519
40 Schultz M, Moore K, Foote A W. Bacterial ventriculitis and duration of ventriculostomy catheter insertion. J Neurosci Nurs . 1993; 25 158-164
41 Kanter R K, Weiner L B, Patti A M, Robson L K. Infectious complications and duration of intracranial pressure monitoring. Crit Care Med . 1985; 13 837-839
42 Mayhall C G, Archer N H, Lamg V A. Ventriculostomy-related infections. A prospective epidemiologic study. N Engl J Med . 1984; 310 553-559
43 Findlay J, Weir B, Steinke D. Effect of intrathecal thrombolytic therapy on subarachnoid clot and chronic vasospasm in a primate model of SAH. J Neurosurg . 1988; 69 723-735
44 Findlay J, Weir B, Gordon P. Safety and efficacy of intrathecal thrombolytic therapy in a primate model of cerebral vasospasm. Neurosurgery . 1989; 24 491-498
45 Findlay J M, Weir B K, Kanamaru K. Intrathecal fibrinolytic therapy after subarachnoid hemorrhage: Dosage study in a primate model and review of the literature. Can J Neurol Sci . 1989; 16 28-40
46 Findlay J M, Weir B K, Kassell N F, Disney L B, Grace M G. Intracisternal recombinant tissue plasminogen activator after aneurysmal subarachnoid hemorrhage. J Neurosurg . 1991; 75 181-188
47 Zabramski J M, Spetzler R F, Lee K S. Phase I trial of tissue plasminogen activator for the prevention of vasospasm in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg . 1991; 75 189-196
48 Kodama N, Sasaki T, Kawakami M. Prevention of vasospasm: Cisternal irrigation therapy with urokinase and ascorbic acid. In: Sano K, Takakura K, Kassell N, eds. Cerebral Vasospasm: Proceedings of the IVth International Conference on Cerebral Vasospasm, Tokyo, 1990 Tokyo, Japan: University of Tokyo Press 1990: 292-296
49 Mizoi K, Yoshimoto T, Takahashi A, Fujiwara S, Koshu K, Sugawara T. Prospective study on the prevention of cerebral vasospasm by intrathecal fibrinolytic therapy with tissue-type plasminogen activator. J Neurosurg . 1993; 78 430-437
50 Mizoi K, Yoshimoto T, Fujiwara S, Sugawara T, Takahashi A, Koshu K. Prevention of vasospasm by clot removal and intrathecal bolus injection of tissue-type plasminogen activator: Preliminary report. Neurosurgery . 1991; 28 807-812
51 Sasaki T, Ohta T, Kikuch H. Preliminary clinical trial of intrathecal rt-PA (TD-2061) for the prevention of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. No To Shinkei . 1992; 44 1001-1008
52 Usui M, Saito N, Hoya K, Todo T. Vasospasm prevention with postoperative intrathecal thrombolytic therapy: A retrospective comparison of urokinase, tissue plasminogen activator, and cisternal drainge alone. Neurosurgery . 1994; 34 235-244
53 Findlay J M, Kassell N F, Weir B K. A randomized trial of intraoperative, intracisternal tissue plasminogen activator for the prevention of vasospasm. Neurosurgery . 1995; 37 168-176
54 Pang D, Sclabassi R J, Horton J A. Lysis of intraventricular blood clot with urokinase in a canine model: Part 1. Canine intraventricular blood cast model. Neurosurgery . 1986; 19 540-546
55 Pang D, Sclabassi R J, Horton J A. Lysis of intraventricular blood clot with urokinase in a canine model: Part 3. Effects of intraventricular urokinase on clot lysis and posthemorrhagic hydrocephalus. Neurosurgery . 1986; 19 553-572
56 Pang D, Sclabassi R J, Horton J A. Lysis of intraventricular blood clot with urokinase in a canine model: Part 2. In vivo safety study of intraventricular urokinase. Neurosurgery . 1986; 19 547-552
57 Findlay J M, Grace M G, Weir B K. Treatment of intraventricular hemorrhage with tissue plasminogen activator. Neurosurgery . 1993; 32 941-947
58 Mayfrank L, Lippitz B, Groth M, Bertalanffy H, Gilsbach J M. Effect of recombinant tissue plasminogen activator on clot lysis and ventricular dilatation in the treatment of severe intraventricular haemorrhage. Acta Neurochir . 1993; 122 32-38
59 Rohde V, Schaller C, Hassler W E. Intraventricular recombinant tissue plasminogen activator for lysis of intraventricular haemorrhage. J Neurol Neurosurg Psychiatry . 1995; 58 447-451
60 Shen P H, Matsuoka Y, Kawajiri K. Treatment of intraventricular hemorrhage using urokinase. Neurol Med Chir (Tokyo) . 1990; 30 329-333
61 Todo T, Usui M, Takakura K. Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. J Neurosurg . 1991; 74 81-86
62 Schwarz S, Schwab S, Steiner H H, Hacke W. Secondary hemorrhage after intraventricular fibrinolysis: A cautionary note: A report of two cases. Neurosurgery . 1998; 42 659-662
63 Akdemir H, Selcuklu A, Pasaoglu A, Oktem I S, Kavuncu I. Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. Neurosurg Rev . 1995; 18 95-100
64 Coplin W M, Vinas F C, Agris J M. A cohort study of the safety and feasibility of intraventricular urokinase for nonaneurysmal spontaneous intraventricular hemorrhage. Stroke . 1998; 29 1573-1579
65 Grabb P A. Traumatic intraventricular hemorrhage treated with intraventricular recombinant-tissue plasminogen activator: Technical case report. Neurosurgery . 1998; 43 966-969
66 Goh K Y, Poon W S. Recombinant tissue plasminogen activator for the treatment of spontaneous adult intraventricular hemorrhage. Surg Neurol . 1998; 50 526-531
67 Naff N J, Tuhrim S, Williams M S, Hanley D F. Intraventricular urokinase injections speed blood clot resolution in IVH: A quantitative analysis. Abstract. Joint Section on Cerebrovascular Surgery Annual Meeting. Nashville, TN 1999
68 Marder V J, Sherry S. Thrombolytic therapy: Current status (1). N Engl J Med . 1988; 318 1512-1520
69 Marder V J, Sherry S. Thrombolytic therapy: Current status (2). N Engl J Med . 1988; 318 1585-15951