Safety of Intraventricular Hemorrhage (IVH) Thrombolysis Based on CT Localization of External Ventricular Drain (EVD) Fenestrations and Analysis of EVD Tract Hemorrhage
Neurocritical Care ,

Jackson DA et al. – Intraventricular recombinant tissue plasminogen activator (rt–PA) appears to be relatively safe especially when all EVD fenestrations are within the ventricle and reduces IVH burden similar to other studies. The authors describe a CT–based EVD tract hemorrhage grading scale to evaluate EVD tract hemorrhage before and after thrombolysis, and a bone–window technique to evaluate EVD fenestrations prior to IVH thrombolysis. Further research is needed evaluating these imaging techniques in regard to intraventricular thrombolytic safety and EVD tract hemorrhage.

Methods
  • A retrospective review was conducted for patients receiving intraventricular rt-PA for IVH from January 2004 to September 2009.
  • Safety was assessed by the presence of EVD tract hemorrhage by CT at baseline after EVD placement, worsening hemorrhage after rt-PA, and CSF infection.
  • IVH volumetrics were assessed by the Le Roux score and outcomes by Glasgow Outcome Scale and modified Rankin Scale.

Results
  • Twenty-seven patients received rt-PA for IVH.
  • Median dose was 2mg (range 0.3–8) and a median of two doses (range 1–17) were given.
  • Worsening EVD catheter tract hemorrhage after rt-PA was 46.7 %, with a significantly higher incidence of worsening tract hemorrhage seen with incorrectly placed EVDs (p = 0.04).
  • IVH hematoma burden decreased by a median Le Roux score of 10 (range 3–16) prior to rt-PA to 4 (range 0–16) after rt-PA.
  • There were no central nervous system bacterial infections.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Neurology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Neurology Articles

1 Zolpidem and the risk of Parkinson's disease: A nationwide population-based study Journal of Psychiatric Research, August 1, 2014    Clinical Article

2 Consumption of nuts and legumes and risk of stroke: a meta-analysis of prospective cohort studies Nutrition, Metabolism & Cardiovascular Diseases, July 28, 2014    Evidence Based Medicine    Clinical Article

3 Intracranial hemorrhage risk with the new oral anticoagulants: A systematic review and meta-analysis Journal of Neurology, September 2, 2014    Evidence Based Medicine    Review Article

4 Patent foramen ovale closure versus medical therapy for stroke prevention: meta analysis of randomized trials and review of heterogeneity in meta analyses Canadian Journal of Cardiology, August 7, 2014    Evidence Based Medicine    Review Article    Clinical Article

5 Occupational exposure to extremely low-frequency magnetic fields and brain tumor risks in the INTEROCC Study Cancer Epidemiology, Biomarkers & Prevention, September 9, 2014

6 Antiplatelet strategies for secondary prevention of stroke and TIA Current Atherosclerosis Reports, September 11, 2014    Review Article

7 Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES European Heart Journal, September 8, 2014    Clinical Article

8 Intracranial hemorrhage mortality in atrial fibrillation patients treated with dabigatran or warfarin Stroke, August 14, 2014    Clinical Article

9 Trial of ORG 10172 in acute stroke treatment (TOAST) classification and vascular territory of ischemic stroke lesions diagnosed by diffusion-weighted imaging Full Text Journal of the American Heart Association, September 16, 2014    Free full text    Clinical Article

10 Antiepileptics in migraine prophylaxis: An updated Cochrane review Cephalalgia, August 14, 2014    Clinical Article

11 Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial European Heart Journal, September 17, 2014    Clinical Article

12 Initial 3-weeks’ apixaban versus dual-antiplatelet therapy (clopidogrel and aspirin) followed by clopidogrel alone in high-risk patients with acute non-disabling cerebrovascular events (adance): study protocol for a randomized controlled trial Clinical Drug Investigation, September 15, 2014    Clinical Article

13 Oral anticoagulants for stroke prevention in atrial fibrillation Current Problems in Cardiology, September 22, 2014    Review Article

14 Early deterioration after thrombolysis plus aspirin in acute stroke Stroke, September 26, 2014    Clinical Article

15 Coronary artery calcification, intima-media thickness, and ankle-brachial index are complementary stroke predictors Stroke, August 29, 2014    Clinical Article

16 Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: A nationwide cohort study American Journal of Medicine, September 29, 2014    Clinical Article

17 Potassium intake and risk of stroke in women with hypertension and nonhypertension in the women’s health initiative Stroke, September 24, 2014    Clinical Article

18 Clinical trials in acute ischemic stroke CNS Drugs, September 4, 2014    Review Article

19 Vitamin D and sleep disorders Full Text Nature and Science of Sleep, August 13, 2014    Free full text    Clinical Article

20 Bleeding risk, physical functioning, and non-use of anticoagulation among patients with stroke and atrial fibrillation QJM: An International Journal of Medicine, September 19, 2014    Clinical Article

Indexed Journals in Neurology: Current Opinion in Neurology, Stroke, Seizure, Cephalgia, Brain Injurymore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close