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Journal of Korean Neurosurgical Society 1990;19(1): 45-51.
Clinical Analysis of External Ventricular Drainage in the Treatment of Intraventricular Hemorrhage.
Chang Myung Choi, Shi Hun Song, Youn Kim
Department of Neurosurgery, College of Medicine, Chungnam National University, Daejeon, Korea.
A series of 54 adult patients with intraventricular hemorrhage(IVH) diagnosed by computed tomography(CT) scan and treated with external ventricular drainage were reviewed. In cases who occurred poor drainage of bloody cerebrospinal fluid obstruction, irrigation with urokinase solution(6,000 U/ml) was tried. Hypertension and ruptured aneurysms accounted for 65% of the cases. Although most cases showed poor prognosis, we experienced dramatic improvements in four comatose patients who had fixed dilated pupils after spontaneous intraventricular hemorrhage with secondary acute hydrocephalus. We believe ventriculostomy to be effective in managing IVH especially in the early stage before cerebral herniation occurs. This procedure, accomplished by a convenient and relatively simple technique, led to evacuration of intraventricular blood, or the temporary or permanent cessation of progression of the hydrocephalic process, decrease in ventricular size, and normalization of ICP. However, a relatively high incidence of infection was problematic.
Key Words: Intraventricular hemorrhage; CT Scan; ICP; External ventricular drainage; Urokinase; Infection
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