Early Lumbar Drainage Combined With Intrathecal Urokinase Injection for Treatment of Severe Aneurysmal SAH (LD-ITUK)
The LD-ITUK is a multicenter, prospective, randomized, double-blind, blind endpoint, placebo-control design trial. All eligible patients with the diagnosis of severe aSAH will be randomly assigned to the treatment group or the placebo group. Patients in the treatment group will receive standard treatment with the addition of lumbar drainage combined with intrathecal urokinase injection started within 24 hours after aneurysm treatment with 30000 IU urokinase, once a day for 3 consecutive days. Patients in the control group will receive standard treatment with the addition of lumbar drainage combined with intrathecal placebo (0.9%NaCl) injection. The primary outcome measure is favorable functional outcome, defined as a score of 0 to 2 on the modified Rankin Scale (mRS), at 6 months after aneurysmal SAH. Primary outcome will be determined by a member of the Independent Committee on Terminal events.
- EligibilityCriteria: Inclusion Criteria:  Patient's age ≥ 18 years First occurrence of aneurysmal subarachnoid hemorrhage Patients without any craniotomy treatment before onset Hunt-Hess grade III-V mRS grade 0 or 1 before onset Aneurysm treatment within 48 hours of onset Informed consent given by the subject or guardian  Exclusion Criteria:  Subarachnoid hemorrhage caused by arteriovenous malformation or moyamoya disease or other cerebrovascular disease modified Fisher Scale grade 0 Prothrombin time (PT) and activated partial thromboplastin time (APTT) are less than 2 times the extended range Absolute contraindications for lumbar puncture (e.g., brain hernia, puncture site infection) Patients with a life expectancy of less than 1 year due to other causes Other concomitant serious diseases that are difficult to treat; Pregnant woman Patients who were known to be allergic to urokinase and excipients or had a history of severe allergy and were deemed unsuitable for inclusion by the investigators Participated in another interventional clinical trial within 30 days before randomization Other reasons deemed unsuitable for study participation by the investigator - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult