Failure of fibrinolytic endoventricular treatment to prevent neonatal post-haemorrhagic hydrocephalus. A case-control trial

Childs Nerv Syst. 1997 Feb;13(2):73-6. doi: 10.1007/s003810050045.

Abstract

Post-haemorrhagic hydrocephalus is assumed to result from obstruction of the cerebrospinal fluid (CSF) pathways by blood clots and subsequent chronic infiltration with collagen. The aim of this work was to evaluate the possibility of preventing permanent shunt dependence by enhancing the endoventricular fibrinolysis by means of an endoventricular streptokinase infusion in babies affected by posthaemorrhagic ventricular dilation. A case-control trial was carried out in 12 neonates affected by intraventricular haemorrhage and subsequent progressive ventriculomegaly. Six of them were treated with 20,000 U/day of streptokinase infused over 96 h through a percutaneous ventricular catheter. Our results show that the percentage of shunted babies was identical in treated and control patients despite the enhancement of endoventricular fibrinolysis obtained in all treated patients. On the basis of our results we do not recommend intraventricular streptokinase infusion for routine use in post-haemorrhagic ventricular dilatation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Case-Control Studies
  • Cerebral Hemorrhage / complications*
  • Cerebral Ventricles* / drug effects
  • Female
  • Humans
  • Hydrocephalus / prevention & control*
  • Infant, Newborn
  • Injections, Intraventricular
  • Male
  • Streptokinase / administration & dosage*
  • Thrombolytic Therapy*
  • Treatment Failure
  • Ventriculoperitoneal Shunt

Substances

  • Streptokinase