Abstract:
OBJECTIVE AND IMPORTANCE:Traumatic intraventricular hemorrhage (IVH) can result in association with acute obstructive hydrocephalus, repetitive malfunction of external ventricular drains (EVDs), and uncontrollable increased intracranial pressure. We report a case showing the safe and effective use of intraventricular recombinant-tissue plasminogen activator in a child with severe brain injury and acute hydrocephalus from IVH. CLINICAL PRESENTATION:A 15-year-old male patient presented to us after a motor vehicle accident with bilateral extensor posturing, intracerebral and IVH, and acute obstructive hydrocephalus. INTERVENTION:A right EVD was placed and functioned only transiently. A left EVD was placed and functioned only transiently. Because of the inability to maintain ventricular drainage, rising intracranial pressure, and worsening clinical status, 5 mg of recombinant-tissue plasminogen activator was injected through each EVD. Excellent EVD function was obtained quickly, with control of intracranial pressure and improvement in clinical status and without hemorrhagic complication. CONCLUSION:With obstructive hydrocephalus secondary to acute traumatic IVH that cannot be controlled with EVD because of recurrent obstruction from intraventricular blood, intraventricular recombinant-tissue plasminogen activator can be effective and safe, despite preexisting multiple hemorrhagic intracranial injuries.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Grabb PAdoi
10.1097/00006123-199810000-00150subject
Has Abstractpub_date
1998-10-01 00:00:00pages
966-9issue
4eissn
0148-396Xissn
1524-4040journal_volume
43pub_type
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