• Sven O Eicker, Kerim Beseoglu, Nima Etminan, Jason Perrin, Arzu Taskin, Hans-Jakob Steiger, and Daniel Hänggi.
• Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany. eicker.s@mac.com
• Acta Neurochir. Suppl. 2012 Jan 1;114:323-8.

ObjectiveThe current clinical prospective randomized phase II study was initiated in order to analyze the effect of enhanced washout by discontinuous intraventricular thrombolysis in combination with low-frequency head-motion therapy on side effects, clot clearance rate, cerebral vasospasm and clinical outcome after severe subarachnoid hemorrhage (SAH).MethodsData from 40 adult patients with aneurysmal SAH were included in this interim analysis. Patients randomized to the study group achieved additional intraventricular application of rt-PA (Actilyse(®)) bolus 5 mg every 12 h and lateral rotational therapy (RotoRest(®)). Clot clearance rate was evaluated based on computed tomography (CT). Delayed cerebral ischemia (DCI) and early clinical outcome of patients were determined.ResultsNo severe side effects due to the combined therapy were documented. The clot clearance rate was significantly higher in the study group than in the control group regarding the cranial and basal CT slices (p = 0.003 cranial slices and p = 0.037 basal slices). Delayed ischemic neurological deficits (DIND) were increased in the control group (p = 0.016).ConclusionThe present study demonstrates that a combination of intraventricular thrombolysis and lateral rotational therapy is not associated with a higher complication rate. Furthermore, the therapy leads to a significant acceleration of the clot clearance rate.

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