OBJECTIVE AND IMPORTANCE: To hasten the lysis of @entity548 , intraventricular administration of recombinant tissue plasminogen activator (rt-PA) or urokinase has been advocated as an effective and safe treatment for @entity1 with @entity548 . Until now, cases of secondary @entity548 after intraventricular fibrinolysis, to our knowledge, have not been reported in the literature. We present a report of two @entity1 with clinically significant @entity548 complications associated with intraventricular infusion of rt-PA. CLINICAL PRESENTATION: Both @entity1 , a 42-year-old @entity1 ( @entity1 1) and a 70-year-old @entity1 ( @entity1 2), suffered from @entity101 left-sided @entity548 with ventricular extension and @entity2554 . INTERVENTION: Both @entity1 required external ventricular drainage and were treated with intraventricular rt-PA. In @entity1 1, a secondary @entity548 occurred 20 minutes after the first instillation of 2 mg of rt-PA and was associated with a @entity909 . Treatment with rt-PA was stopped, and the @entity1 needed a permanent shunt. In @entity1 2, intraventricular subsequent @entity548 was noted 4 hours after the second 4-mg dose of rt-PA, clinically apparent as anisocoria. In @entity1 2, rt-PA administration was continued without further complications. In both @entity1 , a second external ventricular drainage was required after secondary @entity548 . CONCLUSION: Intraventricular lysis is a potentially hazardous therapy. To weigh the potential benefits against the potential risks, a controlled study of this promising new treatment is urgently warranted.

XXXX after intraventricular fibrinolysis: a cautionary note: a report of two cases.

@entity1 :: ('9606', 'Species') :: ['woman', 'patients', 'patient', 'Patient', 'man'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertensive'] @entity548 :: ('MESH:D006470', 'Disease') :: ['intraventricular hemorrhages', 'thalamic hemorrhage', 'intraventricular hemorrhage', 'hemorrhage', 'bleeding'] @entity909 :: ('MESH:D014474', 'Disease') :: ['sudden loss of consciousness'] @entity2554 :: ('MESH:C563906', 'Disease') :: ['ventricular dilatation']
@entity548 :: (MESH:D006470,Disease) :: ['Secondary hemorrhage']
