Hydrocephalus secondary to intraventricular hemorrhage in the prematur
e infant is common and is secondary to the presence of blood in the su
barachnoid space. Rapid clearance of the blood may reduce the incidenc
e of permanent hydrocephalus and mitigate the need for shunt placement
. We have treated 4 premature infants with posthemorrhagic hydrocephal
us with urokinase, a thrombolytic agent, instilled into the ventricles
via a surgically paced ventricular access device. The infants were tr
eated with 10,000 IU of urokinase twice a day for 1 week. No adverse r
eactions have occurred and none of the infants has required shunt plac
ement, In a group of historical controls, the shunt rate was 87%.