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AJNR - American Journal of Neuroradiology

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Intrathecal Urokinase Infusion Through a Microcatheter into the Cisterna Magna to Prevent Cerebral Vasospasm: Experimental Study in Dogs

Takamasa Mizuno^a, Jun-ichiro Hamada^a, Yutaka Kai^a, Tatemi Todaka^a, Motohiro Morioka^a and Yukitaka Ushio^a

^a From the Department of Neurosurgery, Kumamoto University School of Medicine, Japan

View larger version (105K): [in a new window]   FIG 1. A and B, Photographs of gross specimens show the ventral surface of the brain stem in dogs with experimental SAH at 24 hours after UK injection into the LS or CM. In the LS specimen (A), there is strong persistence of the clot. However, in the CM specimen (B), the clot around the brain stem has almost disappeared.

View larger version (152K): [in a new window]   FIG 2. A–C, Representative serial angiograms of the canine BA in the control (A), LS (B), and CM (C) groups. At 24 hours after SAH induction, UK (1000 IU/kg) or physiologic saline was delivered into the CM or LS. In the control group, physiologic saline was injected into the CM. The diameter of the BA was dilated on day 7 in the CM group compared with the other two groups. By day 14, it almost returned to the pre-SAH size.

View larger version (10K): [in a new window]   FIG 3. Graphic presentation of the percent changes in the mean diameter of the BA. The BA in the CM group was dilated on days 7, 10, and 14. No dilation was observed in the LS and control groups. There were significant differences between the CM group and the LS and control groups on days 7, 10, and 14 (* indicates P < .05).

View larger version (15K): [in a new window]   FIG 4. Time-course changes in the UK concentration in the CM after intrathecal injection. UK (1000 IU/kg) was injected into the CM or LS. Differences between the groups were significant until 30 minutes after injection (* indicates P < .05).

View larger version (13K): [in a new window]   FIG 5. Time-course changes in the UK concentration at the sylvian fissure after intrathecal injection. UK (1000 IU/kg) was injected into the CM or LS. Differences between the groups were significant until 105 minutes after injection (* indicates P < .05).