INTRAVENTRICULAR STREPTOKINASE INFUSION IN ACUTE POSTHEMORRHAGIC HYDROCEPHALUS

Neonatal post-haemorrhagic hydrocephalus is a clinical condition with a high mortality and long-term morbidity. Its clinical management is d ifficult. and not well standardized. We describe the case of a term ba by suffering from acute Intracranial hypertension caused by an intrave ntricular and thalamic haemorrhage. In this case, the external ventric ular drain inserted to central intracranial pressure was ineffective b ecause of repeated obstructions due to blood clots. Continuous intrave ntricular infusion of streptokinase of 20 000 U/day allowed quick lysi s of the clots, drainage of the cerebrospinal fluid and relief from th e coma. Although it did not prevent a permanent ventriculoperitoneal s hunt, we obtained reabsorption of the intraventricular haemorrhage wit hout rebleeding complications. We suggest the use of low-dose fibrinol ytic infusion through an external drain for the treatment of acute int racranial hypertension following intraventricular haemorrhage in term infants.