Unit:
Κατεύθυνση Κλινική και Πειραματική ΝευροχειρουργικήLibrary of the School of Health Sciences
Author:
Savvanis Georgios
Supervisors info:
Λάμπης Σταυρινού, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Στράντζαλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Θεοδόσης Καλαματιανός, Επιστημονικός Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Thrombolytic therapy in subarachnoid hemorrhage: a scoping review
Translated title:
Thrombolytic therapy in subarachnoid hemorrhage: a scoping review
Summary:
Introduction: Subarachnoid hemorrhage causes blood presence
outside brain vessels of the circle of Willis and sometimes blood is
also found in the ventricular system. Subarachnoid presence of
blood is associated with cerebral vasospasm, which may result in
secondary neurologic deficits and post-hemorrhagic
hydrocephalus. In cases of intraventricular extension, acute
obstructive hydrocephalus may occur as well. It therefore makes
sense to target subarachnoid and intraventricular blood using
thrombolytic agents to reduce such secondary complications. This
scoping review aims to assess what has been done in dealing with
ways to obtain subarachnoid blood clearance.
Materials and methods: A search was conducted using the
Pubmed, Medline, Embase and Cochrane databases. The algorithm
used was ((Thrombolysis) OR (thrombolytic therapy)) AND
(subarachnoid hemorrhage). Articles were excluded if they were
about intravascular thrombolysis. No experimental papers on
animals were included. Research was limited to articles where all
patients taken into consideration were having aneurysmal
subarachnoid hemorrhage due to saccular aneurysms, with
possible intraventricular extension, and were treated surgically or
endovascularly.
Results: Research in the Pubmed database yielded 399 results.
After exclusion criteria were applied, 25 articles were finally
selected for elaboration. All studies proved that intrathecal
thrombolysis contributes to an earlier intracisternal and/or
intraventricular blood clearance. A trend towards clinical
amelioration in the thrombolysed patient group was observed in
the studies that reported comparisons between treatments.
Conclusion: Intrathecal (intracisternal and intraventricular)
thrombolysis is a feasible and effective method for accelerating
intracisternal or intra-ventricular blood clots. Further studies on
larger patient series are required to obtain statistically significant
conclusions on the clinical outcomes.
Main subject category:
Health Sciences
Keywords:
Thrombolysis, Subarachnoid hemorrhage
