Image-Guided Catheter Evacuation and Thrombolysis for Intracerebral Hematoma

Indications

• Spontaneous intracerebral hemorrhage (ICH).

• Deep-seated and lobar hematomas with suspected underlying hypertension or cerebral amyloid angiopathy.

• Moderate-sized and large hematomas (> 20 mL).

• Normal coagulation parameters (international normalized ratio [INR] < 1.3, prothrombin time < 14, and partial thromboplastin time < 30–32 seconds or local normal range), platelet counts greater than 100,000/μL, and no evidence of platelet dysfunction other than aspirin effect (i.e., known use of clopidogrel [Plavix]).

• Stable clot volume (as evidenced by radiographic imaging 6 hours later).

• Stable or slowly declining neurologic condition.