Intraventricular hemorrhage and its fibrinolytic treatment: literature review
DOI:
https://doi.org/10.25305/unj.104497Keywords:
intraventricular hemorrhage, fibrinolytics, intraventricular fibrinolysis, occlusive hydrocephalus, external ventricular drainageAbstract
The review is dedicated to intraventricular hemorrhage (IVH) and its treatment with topical intraventricular fibrinolysis (IVF). We evaluated many clinical factors typical for IVH: etiology, classifications, symptoms, diagnostics, qualitative and quantitative results and in case of re-bleeding the breakdown site where blood enters venricular system.
The paper considers main elements of IVF evaluated, namely indications, external ventricular drain (EVD) techniques, fibrinolytic administration through the drainage catheter vs intratecali, fibrinolytic dosage used (urokinase, tissue plasminogen activator).
The paper describes the results following IVH: mortality, main complications (re-bleeding, ventriculitis, shunt-dependence ect) and functional outcome. This article reviews the general points associated with IVH and its treatment with topical IVF.
References
1. Hemphill JC 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, Fung GL, Goldstein JN, Macdonald RL, Mitchell PH, Scott PA, Selim MH, Woo D. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke. 2015;46(7):2032-60. [CrossRef] [PubMed]
2. Flint A, Roebken A, Singh V. Primary intraventricular hemorrhage: yield of diagnostic angiography and clinical outcome. Neurocrit Care. 2008;8(3):330-6. [CrossRef] [PubMed]
3. Nyquist P, Hanley DF. The use of intraventricular thrombolytics in intraventricular hemorrhage. J Neurol Sci. 2007;261(1-2):84-8. [CrossRef] [PubMed]
4. Bhattathiri PS, Gregson B, Prasad KS, Mendelow AD. STICH Investigators. Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: results from the STICH trial. Acta Neurochir. 2006;96:65-8. [CrossRef] [PubMed]
5. Krylov VV, Burov SA. Khirurgiya anevrizm golovnogo mozga, oslozhnennykh vnutrizheludochkovymi krovoizliyaniyami [Surgery of brain aneurysms complicated by intraventricular hemorrhage]. In: Khirurgiya anevrizm golovnogo mozga [Surgery of brain aneurysm]; ed. Krylov VV. Vol.1. Moscow: Novoye vremya; 2011. P.392-410. Russian.
6. Krylov VV. Khirurgicheskoye lecheniye vnutrizheludochkovykh krovoizliyaniy pri razryve anevrizm golovnogo mozga [Surgical treatment of intraventricular hemorrhage with rupture brain aneurysm]. Voprosy neyrokhirurgii. 1993;1:31-5. Russian.
7. Donauer E, Reif J, Al-Khalaf B, Mengedoht E, Faubert C. Intraventricular haemorrhage caused by aneurysms and angiomas. Acta Neurochir. 1993;122(1-2):23-31. [CrossRef] [PubMed]
8. Gaberel T, Magheru C, Parienti J, Huttner H, Vivien D, Emery E. Intraventricular fibrinolysis versus external ventricular drainage alone in intraventricular hemorrhage: a meta-analysis. Stroke. 2011;42(10):2776-81. [CrossRef] [PubMed]
9. Litrico S, Almairac F, Gaberel T, Ramakrishna R, Fontaine D, Sedat J, Lonjon M, Paquis P. Intraventricular fibrinolysis for severe aneurysmal intraventricular hemorrhage: a randomized controlled trial and meta-analysis. Neurosurg Rev. 2013;36(4):523-31. [CrossRef] [PubMed]
10. Akdemir H, Selзuklu A, Paşaoğlu A, Цktem I, Kavuncu I. Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. Neurosurg Rev. 1995;18(2):95-100. [CrossRef] [PubMed]
11. Naff N, Williams MA, Keyl PM, Tuhrim S, Bullock MR, Mayer SA, Coplin W, Narayan R, Haines S, Cruz-Flores S, Zuccarello M, Brock D, Awad I, Ziai WC, Marmarou A, Rhoney D, McBee N, Lane K, Hanley DF Jr. Low-dose recombinant tissue-type plasminogen activator enhances clot resolution in brain hemorrhage: the intraventricular hemorrhage thrombolysis trial. Stroke. 2011;42(11):3009-16. [CrossRef] [PubMed]
12. Jackson DA, Patel AV, Darracott RM, Hanel RA, Freeman WD, Hanley DF. Safety of intraventricular hemorrhage (IVH) thrombolysis based on CT localization of external ventricular drain (EVD) fenestrations and analysis of EVD tract hemorrhage. Neurocrit Care. 2013;19(1):103-10. [CrossRef] [PubMed]
13. Khan NR, Tsivgoulis G, Lee SL, Jones GM, Green CS, Katsanos AH, Klimo P Jr, Arthur AS, Elijovich L, Alexandrov AV. Fibrinolysis for intraventricular hemorrhage: an updated meta-analysis and systematic review of the literature. Stroke. 2014;45(9):2662-9. [CrossRef] [PubMed]
14. Basaldella L, Marton E, Fiorindi A, Scarpa B, Badreddine H, Longatti P. External ventricular drainage alone versus endoscopic surgery for severe intraventricular hemorrhage: a comparative retrospective analysis on outcome and shunt dependency. Neurosurg Focus. 2012;32(4):E4. [CrossRef] [PubMed]
15. Chen CC, Liu CL, Tung YN, Lee HC, Chuang HC, Lin SZ, Cho DY. Endoscopic surgery for intraventricular hemorrhage (IVH) caused by thalamic hemorrhage: comparisons of endoscopic surgery and external ventricular drainage (EVD) surgery. World Neurosurg. 2011;75(2):264-8. [CrossRef] [PubMed]
16. Cucchiara BL. Intraventricular Hemorrhage [Internet]. UpToDate; 2013. [cited 2016 November 28]. Avaliable at: http://www.uptodate.com/contents/intraventricular-hemorrhage?source=search_result&search=intraventricular+hemorrhage&selectedTitle=1%7E116
17. Hinson HE, Hanley DF, Ziai WC. Management of intraventricular hemorrhage. Curr Neurol Neurosci Rep. 2010 Mar;10(2):73-82. [CrossRef] [PubMed]
18. Passero S, Ulivelli M, Reale F. Primary intraventricular haemorrhage in adults. Acta Neurol Scand. 2002;105(2):115-9. [CrossRef] [PubMed]
19. Angelopoulos M, Gupta SR, Azat Kia B. Primary intraventricular hemorrhage in adults: clinical features, risk factors, and outcome. Surg Neurol. 1995;44(5):433-7. [CrossRef] [PubMed]
20. Martн-Fаbregas J, Piles S, Guardia E, Martн-Vilalta JL. Spontaneous primary intraventricular hemorrhage: clinical data, etiology and outcome. J Neurol. 1999;246(4):287-91. [CrossRef] [PubMed]
21. Kumar K, Demeria DD, Verma A. Recombinant tissue plasminogen activator in the treatment of intraventricular hemorrhage secondary to periventricular arteriovenous malformation before surgery: case report. Neurosurgery. 2003;52(4):964-9. [CrossRef] [PubMed]
22. Nyquist P, LeDroux S, Geocadin R. Thrombolytics in intraventricular hemorrhage. Curr Neurol Neurosci Rep. 2007;7(6):522-8. [CrossRef] [PubMed]
23. Nishikawa T, Ueba T, Kajiwara M, Miyamatsu N, Yamashita K. A priority treatment of the intraventricular hemorrhage (IVH) should be performed in the patients suffering intracerebral hemorrhage with large IVH. Clin Neurol Neurosurg. 2009;111(5):450-3. [CrossRef] [PubMed]
24. Roos Y, Hasan D, Vermeulen M. Outcome in patients with large intraventricular haemorrhages: a volumetric study. J Neurol Neurosurg Psychiatry. 1995;58(5):622-4. [CrossRef] [PubMed]
25. Gerard E, Frontera J, Wright C. Vasospasm and cerebral infarction following isolated intraventricular hemorrhage. Neurocrit Care. 2007;7(3):257-9. [CrossRef] [PubMed]
26. Maeda K, Kurita H, Nakamura T, Usui M, Tsutsumi K, Morimoto T, Kirino T. Occurrence of severe vasospasm following intraventricular hemorrhage from an arteriovenous malformation. J Neuurosurg. 1997;87(3):436-9. [CrossRef] [PubMed]
27. Benes VS. Ventricular haemorrhage. Zentralbl Neurochir. 1985;46(4):283-9. [PubMed]
28. Grabb PA. Traumatic intraventricular hemorrhage treated with intraventricular recombinant-tissue plasminogen activator: technical case report. Neurosurgery. 1998;43(4):966-9. [CrossRef] [PubMed]
29. Mьller H, Brock M. Primary intraventricular traumatic hemorrhage. Surg Neurol. 1987;27(4):398-402. [CrossRef] [PubMed]
30. Shirshov AV. Supratentorial'nyye gipertenzivnyye vnutrimozgovyye krovoizliyaniya, oslozhnennyye ostroy obstruktivnoy gidrotsefaliyey i proryvom krovi v zheludochkovuyu sistemu [dissertation]. Moscow (Russia): Institute of Neurology; 2006. Russian. Available at: http://medical-diss.com/medicina/supratentorialnye-gipertenzivnye-vnutrimozgovye-krovoizliyaniya-oslozhnennye-ostroy-obstruktivnoy-gidrotsefaliey-i-proryv#ixzz3x8QclI00
31. Graeb DA, Robertson WD, Lapointe JS, Nugent RA, Harrison PB. Computed tomographic diagnosis of intraventricular hemorrhage. Etiology and prognosis. Radiology. 1982;143(1):91-6. [CrossRef] [PubMed]
32. Krylov VV, Burov SA, Galankina IYe, Dashyan VG. Punktsionnaya aspiratsiya i lokal'nyy fibrinoliz v khirurgii vnutricherepnykh krovoizliyaniy [Puncture aspiration and local fibrinolysis in surgery of intracranial hemorrhage]. Moscow: Avtorskaya Akademiya; 2009. Russian.
33. Krylov VV, Dashyan VG, Burov SA. Khirurgiya gipertenzivnykh vnutrimozgovykh gematom [The surgery of hypertensive intracerebral hematomas ] In: Skvortsov VI, Krylov VV, editors. Gemorragicheskiy insult [Hemorrhagic Stroke]. Moscow: GEOTAR-Media; 2005. p.77-98. Russian.
34. Samadani U, Rohde V. A review of stereotaxy and lysis for intracranial hemorrhage. Neurosurg Rev. 2009;32(1):15-22. [CrossRef] [PubMed]
35. Lapointe M, Haines S. Fibrinolytic therapy for intraventricular hemorrhage in adults. Cochrane Database Syst Rev. 2002;(3):CD003692. [CrossRef] [PubMed]
36. Naff NJ, Hanley DF, Keyl PM, Tuhrim S, Kraut M, Bederson J, Bullock R, Mayer SA, Schmutzhard E. Intraventricular thrombolysis speeds blood clot resolution: results of a pilot, prospective, randomized, double-blind, controlled trial. Neurosurgery. 2004;54(3):577-84. [PubMed]
37. Pang D, Sclabassi RJ, Horton JA. 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(4):553-72. [PubMed]
38. King NK, Lai JL, Tan LB, Lee KK, Pang BC, Ng I, Wang E. A randomized, placebo-controlled pilot study of patients with spontaneous intraventricular haemorrhage treated with intraventricular thrombolysis. J Clin Neurosci. 2012;19(7):961-4. [CrossRef] [PubMed]
39. Staykov D, Wagner I, Volbers B, Huttner HB, Doerfler A, Schwab S, Bardutzky J. Dose effect of intraventricular fibrinolysis in ventricular hemorrhage. Stroke. 2011;42(7):2061-4. [CrossRef] [PubMed]
40. Morgan T, Awad I, Keyl P, Lane K, Hanley D. Preliminary report of the clot lysis evaluating accelerated resolution of intraventricular hemorrhage (CLEAR-IVH) clinical trial. Acta Neurochir Suppl. 2008;105:217-20. [PubMed]
41. Webb AJ, Ullman NL, Mann S, Muschelli J, Awad IA, Hanley DF. Resolution of Intraventricular Hemorrhage Varies by Ventricular Region and Dose of Intraventricular Thrombolytic: The Clot Lysis: Evaluating Accelerated Resolution of IVH (CLEAR IVH) Program. Stroke. 2012;43(6):1666-8. [CrossRef] [PubMed]
42. Hallevi H, Albright KC, Aronowski J, Barreto AD, Martin-Schild S, Khaja AM, Gonzales NR, Illoh K, Noser EA, Grotta JC. Intraventricular hemorrhage: anatomic relationships and clinical implications. Neurology. 2008;70(11):848-52. [CrossRef] [PubMed]
43. Gaberel T, Magheru C, Emery E. Management of non-traumatic intraventricular hemorrhage. Neurosurg Rev. 2012;35(4):485-95. [CrossRef] [PubMed]
44. Findlay JM, Jacka MJ. Cohort study of intraventricular thrombolysis with recombinant tissue plasminogen activator for aneurysmal intraventricular hemorrhage. Neurosurgery. 2004;55(3):532-8. [CrossRef] [PubMed]
45. Varelas PN, Rickert KL, Cusick J, Hacein-Bey L, Sinson G, Torbey M, Spanaki M, Gennarelli TA. Intraventricular hemorrhage after aneurysmal subarachnoid hemorrhage: pilot study of treatment with intraventricular tissue plasminogen activator. Neurosurgery. 2005;56(2):205-13. [CrossRef] [PubMed]
46. Hall B, Parker D Jr, Carhuapoma JR. Thrombolysis for intraventricular hemorrhage after endovascular aneurysmal coiling. Neurocrit Care. 2005;3(2):153-6. [CrossRef] [PubMed]
47. Nieuwkamp DJ, Verweij BH, Rinkel GJ. Massive intraventricular haemorrhage from aneurysmal rupture: patient proportions and eligibility for intraventricular fibrinolysis. J Neurol. 2010;257(3):354-8. [CrossRef] [PubMed]
48. Zorin NA, Garus DV, Grigoruk SP, Garus MV. [Experience in the use of intrathecal fibrinolysis in the surgery of massive ventricular hemorrhages]. Ukrainian Neurosurgical Journal. 2014;(1):4–9. Russian. [Abstract/Full Text]
49. Saribekyan AS. [Surgical treatment of hemorrhagic stroke by the method of puncture aspiration and local fibrinolysis]. Moskow: IC “Letopis”; 2009. Russian.
50. Staykov D, Huttner HB, Struffert T, Ganslandt O, Doerfler A, Schwab S, Bardutzky J. Intraventricular fibrinolysis and lumbar drainage for ventricular hemorrhage. Stroke. 2009;40(10):3275-80. [CrossRef] [PubMed]
51. Yadav Y, Mukerji G, Shenoy R, Basoor A, Jain G, Nelson A. Endoscopic management of hypertensive intraventricular haemorrhage with obstructive hydrocephalus. BMC Neurol. 2007;7:1. [CrossRef] [PubMed]
52. Zhang Z, Li X, Liu Y, Shao Y, Xu S, Yang Y. Application of neuroendoscopy in the treatment of intraventricular hemorrhage. Cerebrovasc Dis. 2007;24(1):91-6. [CrossRef] [PubMed]
53. Gubucz I, Kakuk I, Major O, Szegedi N, Barsi P, Pбnczйl G, Varga D, Ovary C, May Z, Ricsуi G, Kenйz J, Szilбgyi G, Nagy Z. [Effectiveness and safety of intraventricular fibrinolysis in secondary intraventricular hemorrhages (a prospective, randomized study)]. Orv Hetil. 2004;145(31):1609-15. Hungarian. [PubMed]
54. Naff NJ, Carhuapoma JR, Williams MA, Bhardwaj A, Ulatowski JA, Bederson J, Bullock R, Schmutzhard E, Pfausler B, Keyl PM, Tuhrim S, Hanley DF. Treatment of intraventricular hemorrhage with urokinase: effects on 30-Day survival. Stroke. 2000;31(4):841-7. [CrossRef] [PubMed]
55. Rainov NG, Burkert WL. Urokinase infusion for severe intraventricular haemorrhage. Acta Neurochir (Wien). 1995;134(1-2):55-9. [CrossRef] [PubMed]
56. Todo T, Usui M, Takakura K. Treatment of severe intraventricular hemorrhage by intraventricular infusion of urokinase. J Neurosurg. 1991;74(1):81-6. [CrossRef] [PubMed]
57. Ziai WC, Tuhrim S, Lane K, McBee N, Lees K, Dawson J, Butcher K, Vespa P, Wright DW, Keyl PM, Mendelow AD, Kase C, Wijman C, Lapointe M, John S, Thompson R, Thompson C, Mayo S, Reilly P, Janis S, Awad I, Hanley DF. CLEAR III Investigators. A multicenter, randomized, double-blinded, placebo-controlled phase III study of Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR III). Int J Stroke. 2014;9(4):536-42. [CrossRef] [PubMed]
58. Huttner HB, Nagel S, Tognoni E, Kцhrmann M, Jьttler E, Orakcioglu B, Schellinger PD, Schwab S, Bardutzky J. Intracerebral hemorrhage with severe ventricular involvement: lumbar drainage for communicating hydrocephalus. Stroke. 2007;38(1):183-7. [CrossRef] [PubMed]
59. Volbers B, Wagner I, Willfarth W, Doerfler A, Schwab S, Staykov D. Intraventricular fibrinolysis does not increase perihemorrhagic edema after intracerebral hemorrhage. Stroke. 2013;44(2):362-6. [CrossRef] [PubMed]
60. Nieuwkamp DJ, de Gans K, Rinkel GJ, Algra A. Treatment and outcome of severe intraventricular extension in patients with subarachnoid or intracerebral hemorrhage: a systematic review of the literature. J Neurol. 2000;247(2):117-21. [CrossRef] [PubMed]
61. Ziai WC, Melnychuk E, Thompson CB, Awad I, Lane K, Hanley DF. Occurrence and impact of intracranial pressure elevation during treatment of severe intraventricular hemorrhage. Crit Care Med. 2012;40(5):1601-8. [CrossRef] [PubMed]
62. Fabiano AJ, Gruber TJ, Baxter MS. Increased ventriculostomy infection rate with use of intraventricular tissue plasminogen activator: a single-center observation. Clin Neurol Neurosurg. 2013;115(11):2362-4. [CrossRef] [PubMed]
63. Castaсo Бvila S, Corral Lozano E, Vallejo De La Cueva A, Maynar Moliner J, Martнn Lуpez A, Fonseca San Miguel F, Urturi Matos JA, Manzano Ramнrez A. Intraventricular hemorrhage treated with intraventricular fibrinolysis. A 10-year experience. Med Intensiva. 2013;37(2):61-6. [CrossRef] [PubMed]
64. Torres A, Plans G, Martino J, Godino O, Garcia I, Gracia B, Acebes JJ. Fibrinolytic therapy in spontaneous intraventricular haemorrhage: efficacy and safety of the treatment. Br J Neurosurg. 2008;22(2):269-74. [CrossRef] [PubMed]
65. Dunatov S, Antoncic I, Bralic M, Jurjevic A. Intraventricular thrombolysis with rt-PA in patients with intraventricular hemorrhage. Acta Neurol Scand. 2011;124(5):343-8. [CrossRef] [PubMed]
66. Hallevi H, Walker KC, Kasam M, Bornstein N, Grotta JC, Savitz SI. Inflammatory response to intraventricular hemorrhage: time course, magnitude and effect of t-PA. J Neurol Sci. 2012;315(1-2):93-5. [CrossRef] [PubMed]
67. Ducruet AF, Hickman ZL, Zacharia BE, Grobelny BT, Narula R, Guo KH, Claassen J, Lee K, Badjatia N, Mayer SA, Connolly ES Jr. Exacerbation of perihematomal edema and sterile meningitis with intraventricular administration of tissue plasminogen activator in patients with intracerebral hemorrhage. Neurosurgery. 2010;66(4):648-55. [CrossRef] [PubMed]
68. Ziai W, Moullaali T, Nekoovaght-Tak S, Ullman N, Brooks JS, Morgan TC, Hanley DF. No exacerbation of perihematomal edema with intraventricular tissue plasminogen activator in patients with spontaneous intraventricular hemorrhage. Neurocrit Care. 2013;18(3):354-61. [CrossRef] [PubMed]
69. Mould WA, Carhuapoma JR, Muschelli J, Lane K, Morgan TC, McBee NA, Bistran-Hall AJ, Ullman NL, Vespa P, Martin NA, Awad I, Zuccarello M, Hanley DF; MISTIE Investigators. Minimally invasive surgery plus recombinant tissue-type plasminogen activator for intracerebral hemorrhage evacuation decreases perihematomal edema. Stroke. 2013;44(3):627-34. [CrossRef] [PubMed]
70. Mendelow AD, Gregson BA, Fernandes HM, Murray GD, Teasdale GM, Hope DT, Karimi A, Shaw MD, Barer DH. STICH investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365(9457):387-97. [CrossRef] [PubMed]
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