Treatment of Intraventricular Hemorrhage in the Premature Infant with Urokinase

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