The Effect of Intracisternal Urokinase for the Development of Hydrocephalus after Experimental Subarachnoid Hemorrhage.
- Author:
Hun Dae KIM
;
Youn Kwan PARK
;
Yong Gu CHONG
;
Heung Seob CHUNG
;
Jung Keun SUH
;
Hoon Gap LEE
;
Ki Chan LEE
;
Jeong Wha CHU
- Publication Type:Original Article
- Keywords:
Subarachnoid hemorrhage;
Hydrocephalus;
Urokinasa CT scan;
CSF dynamic study
- MeSH:
Absorption;
Adult;
Animals;
Axis, Cervical Vertebra;
Dogs;
Fibrinolysis;
Humans;
Hydrocephalus*;
Hydrodynamics;
Subarachnoid Hemorrhage*;
Urokinase-Type Plasminogen Activator*
- From:Journal of Korean Neurosurgical Society
1990;19(8-9):1198-1209
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The authors has investigated the effect of intracisternal urokinase on the multihemorrhage canine model of chronic post-subarachnoid hemorrhage(SAH) hydrocephalus. Each of 16 adult mongrel dogs was assigned to one of two experimental groups. All animals received a total of 13ml of fresh unheparinized autologous blood via three cisternal injections. Eight animals were treated by intracisternal injection of 20,000 IU of Urokinase every 12 hours for 3 days, and the remaining were not treated. The changes in ventricular volumes were measured by computed tomography(CT) before and 3 months after the initial subarachnoid blood injection. To compare the changes of hydrodynamic properties in chronic phases of post-SAH hydrocephalus, the pressure-volume index(PVI) technique of bolus manipulation of cerebrospinal fluid(CSF) was used to measure the volume-buffering capacity of neural axis and the resistance to the absorption of CSF(before SAH, post-SAH 1 month, 3 months). The final ventricular volume at 3 months of control group was 4 times greater than the initial volume, but Urokinase group less than two times. The mean measured PVI values of control group and Urokinase group were 3.98+/-0.76ml(+/- standard deviation(SD)) and 4.01+/-0.82ml in baseline study, 3.09+/-0.96ml and 3.70+/-0.84ml in post-SAH 3 months. The mean resistance of CSF outflow of control group and Urokinase group were 10.30+/-2.24mm Hg/ml/min), and 10.34+/-1.98mm Hg/ml/min in baseline study. At 1 month and 3 months after SAH control group maintained high absorptive resistance(29.54+/-11.50mm Hg/ml/min, 22.43+/-3.82mm Hg/ml/min), whereas the resistances of Urokinase group were slightly increased and then returned to the original levels(16.04+/-4.87mm Hg/ml/min, 12.87+/-3.06mm Hg/ml/min). The results described in this experimental study indicated that if fibrinolysis of the subarachnoid blood clot can be achieved rapidly after SAH, the complicating chronic hydrocephalus might be prevented.
