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Within 24~48 hours after start of urokinase cisternal irrigation, an extreme amount of hemoglobin derived from the subarachnoid clot was withdrawn. CT number of cerebral cisterns decreased immediately in cases of urokinase cisternal irrigation while the reduction of CT number was slower in cases with cisternal drainage. Cerebral vasodilatory capacity assessed by DIAMOX(R) activated 123IIMP SPECT during the first and second week after subarachnoid hemorrhage showed less limitation in cases with urokinase cisternal irrigation than with cisternal drainage. Angiographical and symptomatic vasospasm were also expressed less severely in cases of urokinase cisternal irrigation than with cisternal drainage, and subsequently, no low density area in CT due to ischemia from vasospasm appeared with urokinase cisternal irrigation. In conclusion, urokinase cisternal irrigation accelerated clearance of subarachnoid clots, followed by reduction of severity of vasospasm and cerebral ischemia.

Effect of Urokinase Cisternal Irrigation on Decrease of Subarachnoid Clot and Cerebral Vasodilatory Capacity during Cerebral Vasospasm