Tissue Plasminogen Activator Levels After Single Intracisternal Injection in Patients With Subarachnoid Hemorrhage
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概要
- 論文の詳細を見る
Tissue plasminogen activator (tPA) levels were investigated in the cisternal fluid of patients with subarachnoid hemorrhage treated with single intracisternal injection of recombinant tPA during radical surgery for ruptured aneurysms. Seven patients received different doses of tPA : two of 400 μg/ml, three of 500 μg/ml, one of 700 μg/ml, and one of 800 μg/ml in a total amount of 20 ml distilled water at pH 7. Cerebrospinal fluid samples were taken directly from the cisternal fluid at 15-minute incubation after injection, immediately after irrigation during surgery, and by lumbar tap 2 days after surgery. Cisternal tPA levels decreased to about 60% of the mean injected doses after 15-minute incubation. Simple linear regression analysis showed these tPA levels after incubation correlated with the initial doses. After copious irrigation with Ringer solution at pH 8, tPA levels decreased rapidly without correlation with the initial doses. After spinal drainage for 2 days, tPA levels further decreased by an order of 10^<-4> to 10^<-6> from the initial dose. These values were still greater than normal controls. The final values of tPA levels were not related to the initial dose. None of the patients suffered from systemic or wound complications. Cisternal tPA injection with increased doses and irrigation may be beneficial for the selective rapid removal of blood clots with controllable safety.
- 日本脳神経外科学会の論文
- 2004-02-15
著者
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HATSUDA Naoki
Department of Neurosurgery, Asahi University Murakami Memorial Hospital
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Matsuda Masayuki
Department of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine
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NAKASU Yoko
Division of Neurosurgery, Shizuoka Cancer Center
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NAKASU SATOSHI
Department of Neurosurgery, Molecular Neurobiology Research Centre, Shiga University of Medical Scie
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Nakasu Yoko
Division Of Neurosurgery Shizuoka Cancer Center
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Hatsuda Naoki
Department Of Neurosurgery Asahi University Murakami Memorial Hospital
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Hatsuda Naoki
Department Of Neurosurgery Shiga University Of Medical Science
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Nakasu Satoshi
Department Of Neurosurgery Shiga University Of Medical Science
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JITO Junya
Department of Neurosurgery, Shiga University of Medical Science
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Jito Junya
Department Of Neurosurgery Fukui Red Cross Hospital
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Jito Junya
Department Of Neurosurgery Shiga University Of Medical Science
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MATSUDA Masayuki
Department of Neurosurgery, Shiga University of Medical Science
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