Stereotactic fibrinolysis of spontaneous intracerebral hematoma using infusion of recombinant tissue plasminogen activator

Abstract

-Purpose: The authors present a prospective study on 10 patients with stereotactic infusion of tissue plasminogen activator (rtPA) intraparenchimal hemorrhage. Methods: Between 1999 and 2000, 10 patients with deep seated hematomas in the basal ganglia were selected for stereotactic infusion of rtPA and spontaneous clot drainage. Results: All cases had about 80% reduction of the hematoma volume in the CT scan at the third day. The intracranial pressure was normalized by the third day too. There were no local or systemic complications with the use of this trombolitic. The results were shown by the Glasgow Outcome Scale with six patients in V, three in IV and one in III after 3 months. Conclusion: Early treatment and drainage with minimally invasive neurosurgery , can make these patients with deep-seated hematomas recover the consciousness and they can be rehabilitated earlier avoiding secondary complications.

Comparison of CT-guided aspiration to key hole craniotomy in the surgical treatment of spontaneous putaminal hemorrhage: a prospective randomized study

“…It is also believed that good outcomes of minimally invasive surgery can be improved with additional methods such as drainage of the hematoma, aspiration through ossicles or pyramidal skulls, or with the application of a hematoma liquefier such as rt-PA, streptokinase, and low-molecularweight heparin. These methods can improve the level of consciousness of patients with deep-seated hematomas, rehabilitate them earlier, and avoid secondary complications [17][18][19].…”

Review of Critical Care and Emergency Approaches to Stroke

“…The initial level of consciousness (ie, severity of injury) was the single strongest predictor of fatal outcome. 16 A small prospective series by Nasser et al 17 offers some hope for developing treatment. This selected group of 10 patients with basal ganglia hematomas was treated with stereotactic rt-PA infusion and spontaneous clot drainage.…”

Local fibrinolysis in surgical treatment of traumatic intracranial hemorrhage

“…Nasser ³ ñï³âàâòîðàмè [27]. Çà мàêñèмàëüíîãî ä³àмåòðà ãåмàòîмè äî 5 ñм â³äðàзó ïðèзíàчàëè 5 мã rt-PA, åêñïîзèö³я 2 ãîä, з ïîäàëü-шèм ïàñèâíèм äðåíóâàííям.…”