Principal Investigator: Dr. Neil Naff
Department of Neurosurgery
Johns Hopkins Medical Center

Site Investigator: Dr. Stephan Mayer
Department of Neurology
Division of Critical Care Neurology

This is a randomized, double-blinded, placebo-controlled multicenter clinical trial to evaluate the effectiveness of intraventricular administration of urokinase on the resolution of intraventricular hemorrhage associated with intracerebral or aneurysmal subarachnoid hemorrhage.

Potential subjects will include patients ages 18- 75, admitted to the NICU for an intraventricular hemorrhage (IVH) who have obstructive hydrocephalus requiring an intraventricular catheter (IVC). Patients will receive intraventricular injection of urokinase or placebo every 12 hours until IVH clot resolution, as confirmed by CT scan. The primary outcome measures are (1) percent rate of intraventricular blood clot resolution as determined by serial CT scans, (2) duration of external ventricular drainage, and (3) the incidence of communicating hydrocephalus at 30 days. Long-term functional outcome will be assessed through a 15 minute telephone interview at 30 days post-bleed, using the Barthel and Rankin Scales.