European Journal of Molecular & Clinical Medicine

Abstract

Aim: To evaluate external ventriculostomy and intraventricular instillation of recombinant tissue
plasminogen activator for management of spontaneous intra-ventricular hemorrhage.
Material and method:The present non-randomized prospective study was done in the
Department of Neurosurgery among 30 patients who underwent external ventriculostomy and
intraventricular instillation of recombinant tissue plasminogen activator at Bangur Institute Of
Neurosciences & SSKM HOSPITAL, IPGME&R, KOLKATA between April 2020 – August
2021. Various parameters studied were GOSE SCORE: 7 days------>30days------>90 days,
Ventriculitis: (0-180days) (y/n), 30 days survival (y/n), worsening hemorrhage during t/t till 72
hr. of last dose (y/n), worsening hemorrhage during t/t > 72 hr. of last dose (y/n), hydrocephalus
during follow up (y/n) and Qol (EQ5D) at 1 month and 3 months.
Results: Mortality was reported among 33.33% of the subjects after 3 months. After seven days,
good recovery was not found in any of the subject but after 1 month and 3 month, good recovery
was reported among 4 (13.33%) and 9 (30%) of the subjects respectively. After 3 months;
vegetative state, severe disability and moderate disability was found in 2, 7 and 2 subjects
respectively. There was significant decrease in clot volume (cc) after the intervention of external
ventriculostomy and intraventricular instillation of recombinant tissue plasminogen activator i.e.
it decreases from 38.23 to 8.11 after 5 days.
Conclusion:rtPAwas efficacious in decreasing the modified GOSE scoresand clot volume of all
study subjects at end of treatment. Ventriculitis was demonstrated only in six subjects