Morphological changes following experimental intraventricular haemorrhage and intraventricular fibrinolytic treatment with recombinant tissue plasminogen activator

被引:46
作者
Mayfrank, L
Kim, Y
Kissler, J
Delsing, P
Gilsbach, JM
Schröder, JM
Weis, J
机构
[1] Univ Klinikum, Rhein Westfal TH Aachen, Neurochirurg Klin, D-52057 Aachen, Germany
[2] Univ Klinikum, Rhein Westfal TH Aachen, Inst Neuropathol, Aachen, Germany
[3] Univ Bern, Inst Pathol, Abt Neuropathol, Bern, Switzerland
关键词
cerebral haemorrhage; intraventricular haemorrhage; ependyma; tissue plasminogen activator;
D O I
10.1007/s004010000219
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Intraventricular haemorrhage (IVH) occurs in up to 50% of patients with primary intracerebral haemorrhage and aneurysmal subarachnoid haemorrhage. It is a significant and independent contributor to mortality and morbidity in these intracranial haemorrhages. Using a model of isolated IVH, we assessed the morphological changes induced by intraventricular bleeding and investigated the effects of intraventricular fibrinolytic treatment following IVH. IVH was induced in 32 pigs by intraventricular infusion of 10 ml autologous blood along with thrombin. The treatment group received an intraventricular injection of 1.5 mg (1 mg/ml) tissue plasminogen activator (tPA) following the injection of blood. The placebo group received the same volume of normal saline. Morphological examinations of the brains were carried out 7 days and 6 weeks following IVH. The ventricles were incompletely filled with blood and significantly enlarged in the placebo group 7 days after the IVH. In contrast, no residual intraventricular clots were visible in the animals treated with tPA, and the diameters of the lateral ventricles had returned to normal within 7 days. Marked losses of the ependymal covering of the ventricular walls were found in the placebo-treated animals, while the ependymal layer was largely intact in the animals treated with tPA. No haemorrhages induced by tPA were observed. The results indicate that intraventricularly administered tPA significantly enhances the lysis of intraventricular blood clots, accelerates the resolution of acute posthaemorrhagic hydrocephalus, and preserves the integrity of the ependymal layer.
引用
收藏
页码:561 / 567
页数:7
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