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KMID : 0359819960250040812
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Journal of Korean Neurosurgical Society
1996 Volume.25 No. 4 p.812 ~ p.818
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The Results of Extraventricular Drainage Combined with Intraventricular Injection of Urokinase for Intraventricular Hematomas
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정영선
김민호/이지영/심기범/홍승관
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Abstract
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The authors applied extraventricular drainage combined with intermittent intraventricular injection of urokinase to 21 patients with intraventricular hematoma and ventricular dilatation. Ten-thousand IU of urokinase was injected every 12 hours
for
3
days. Follow-up CT on day 4 after the treatment showed complete disappearance of the hematoma in the 3rd and 4th ventricles and a small residual hematoma in the occipital horns of lateral ventricles in the majority (14 patients) of the patients.
Obstruction of the drainage catheter did not occur in any case. but transient pleocytosis in CSF study. ventriculitis. and rebleeding complicated 6. 4. and 4 cases. respectively. The duration of extraventricular drainage in the 17 patients
without
major
complications was 3-17 days. The clinical results on discharge were good recovery in 3. moderate disability in 1. severe disability in 4. vegetative state in 6 and death in 7 cases. The decisive events that were thought to have caused vegetative
states
or death in the 13 patients with poor results were low initial GCS in 7. rebleeding in 4 ventriculitis in 1. pneumonia in 1. and unknown in 1 case. The method of extraventricular drainage combined with intermittent intraventricular injection of
urokinase seems useful in removing intraventricular hematomas more rapidly in regards to various other factors that influence the clinical course of severe intraventricular hematomas. further investigation including prospective studies is
necessary
to
determine whether the intraventricular injection of urokinase significantly improves the final outcomes of those patients with severe intraventricular hematomas.
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KEYWORD
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