A Cochrane review searched for trials treating intraventricular haemorrhage with fibrinolytic therapy. One report with 21 patients was found that met the review criteria for randomization. The randomised trial reported improved outcome, reduced mortality and lower incidence of hydrocephalus using intraventricular urokinase but had important design flaws resulting in a biased control group and therefore was excluded.
The reviewers conclude that there is anecdotal evidence suggesting that the intraventricular administration of fibrinolytic agents in intraventricular hemorrhage may be of therapeutic value and safe. Thus far, there are no randomised trials of sufficient size and quality to evaluate the of this treatment modality.