Article Text

PDF
Single versus bilateral external ventricular drainage for intraventricular fibrinolysis in severe ventricular haemorrhage
  1. D Staykov1,
  2. H B Huttner1,
  3. J Lunkenheimer1,
  4. B Volbers1,
  5. T Struffert2,
  6. A Doerfler2,
  7. O Ganslandt3,
  8. E Juettler4,
  9. S Schwab1,
  10. J Bardutzky1
  1. 1
    Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
  2. 2
    Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany
  3. 3
    Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany
  4. 4
    Department of Neurology, University of Heidelberg, Heidelberg, Germany
  1. Correspondence to Dr D Staykov, Neurology Department, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany; dimitre.staykov{at}uk-erlangen.de

Abstract

Background: Intraventricular fibrinolysis (IVF) through bilateral external ventricular drains (EVD) may provide better access of the thrombolytic agent to the intraventricular clot, potentially influencing clot clearance and outcome.

Methods: Patients with spontaneous ganglionic intracerebral haemorrhage (ICH)<40 cm3 and intraventricular haemorrhage (IVH) with acute hydrocephalus have been treated with IVF. The decision for placement of one or two EVDs has been left to the discretion of the treating physician. CT volumetry, the effects on cerebrospinal fluid (CSF) circulation and outcome at 3 months have been analysed for patients with one (group I, n = 13) or two EVDs (group II, n = 14).

Results: No difference was found in clot resolution between the two groups (clot half life 2.1 (SD 1.2) vs 2.4 (1.3) days). A separate analysis of the third and fourth ventricle clearance was similar (1.6 (0.6) versus 1.8 (0.8) days), indicating no difference in reconstitution of CSF circulation. A trend towards a longer EVD duration and higher infection rate was found in the bilateral EVD group. No difference was found in outcome at 3 months.

Conclusions: Our results do not support the use of bilateral EVDs for IVF in patients with severe IVH.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles