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Single dose 30,000 IU per day for continuous 3 days, and the maximum duration of urokinase treatment shall not exceed 5 days. Discontinue medication when third\u002Ffourth ventricular clot clearance, relieved mass effect, or hematoma clearance rate ≥80% on cranial CT.",[13],"Procedure: External ventricular drainage plus Intrathecal Urokinase",{"label":15,"type":16,"description":17,"interventionNames":18},"Intervention Group (EVD + Urokinase + Early Lumbar Cistern Drainage)","EXPERIMENTAL","On the basis of the same EVD and intrathecal urokinase regimen as the control group, early lumbar drainage is performed within 24 hours. CSF drainage speed is controlled below 8 mL\u002Fh, and daily total drainage volume does not exceed 200 mL to maintain stable intracranial pressure.",[19],"Procedure: Lumbar Drainage combined with external ventricular drainage plus Intrathecal Urokinase",[21,27],{"type":22,"name":23,"description":24,"armGroupLabels":25,"otherNames":26},"PROCEDURE","Lumbar Drainage combined with external ventricular drainage plus Intrathecal Urokinase","Early lumbar cistern drainage is performed within 24 hours. CSF drainage speed is controlled below 8 mL\u002Fh, and daily total drainage volume does not exceed 200 mL to maintain stable intracranial pressure.",[15],null,{"type":22,"name":28,"description":29,"armGroupLabels":30,"otherNames":26},"External ventricular drainage plus Intrathecal Urokinase","Patients receive external ventricular drainage combined with intrathecal urokinase injection. Single dose 30,000 IU per day for continuous 3 days; the maximum duration of urokinase treatment shall not exceed 5 days. Discontinue medication when third\u002Ffourth ventricular clot clearance, relieved mass effect, or hematoma clearance rate ≥80% on cranial CT.",[9],[32,35,37],{"name":33,"affiliation":5,"role":34},"Shigang Lv, MD","PRINCIPAL_INVESTIGATOR",{"name":36,"affiliation":5,"role":34},"Miaojing Wu, MD",{"name":38,"affiliation":5,"role":39},"Xingen Zhu, Prof","STUDY_CHAIR",[41],{"name":42,"role":43,"phone":44,"phoneExt":26,"email":45},"Ping Hu, MD","CONTACT","+86 13097286794","hp666edu@163.com",[47,62,73,84,92,103,111,119,130,142,153,164,175,183,194,205,216,226,237,243,254,265,277,288,299,310,321,332,343],{"facility":48,"status":26,"city":49,"state":50,"zip":26,"country":51,"countryCode":52,"cosmosGeoPoint":53,"geoPoint":58,"contacts":59},"Fuzhou First People's 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with stable clinical condition before randomization.\n* External ventricular drainage performed within 48 hours of symptom onset.\n* Randomization completed within 24 hours after EVD placement.\n* Pre-morbid modified Rankin Scale (mRS) score of 0 or 1.\n* Written informed consent obtained from the participant or their legally authorized representative.\n\nExclusion Criteria:\n\n* Suspected or untreated ruptured intracranial aneurysm, arteriovenous malformation (AVM), or intracranial tumor, unless excluded by vascular imaging. Previously treated aneurysm or AVM must have been completed at least 3 months prior to enrollment.\n* Choroidal vascular malformation or moyamoya disease.\n\n  • Long-term oral anticoagulant use, persistent coagulation dysfunction, or known allergy to urokinase.\n* Platelet count \\\u003C 100×10⁹\u002FL or INR \\> 1.4.\n* Absolute contraindications to lumbar cistern drainage or external ventricular drainage, such as cerebral hernia or infection at the puncture site.\n* Infratentorial hemorrhage volume ≥ 10 mL.\n* Thalamic hemorrhage ≥ 10 mL, or accompanied by midbrain extension, oculomotor nerve palsy, or fixed dilated pupil.\n* Hemiplegia with muscle strength grade 0 or 1.\n* Active bleeding in the gastrointestinal, genitourinary, or respiratory system.\n* Multiple ecchymoses or petechiae suggesting a bleeding tendency.\n* Expected survival time less than 6 months.\n* Severe, untreatable concomitant systemic diseases.\n* Pregnancy.\n* Participation in other interventional clinical trials within 30 days prior to randomization.\n* Any other condition deemed inappropriate for enrollment by the investigator(s).","ALL","18 Years","85 Years",{"count":371,"type":372},392,"ESTIMATED","INTERVENTIONAL",[375],"NA","This is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) trial comparing the addition of early lumbar drainage to standard care in patients with intraventricular hemorrhage (IVH) in China. The primary objective is to evaluate whether early lumbar drainage improves long-term functional outcomes at 180 days, as measured by the modified Rankin Scale (mRS), and reduces complications in patients treated with external ventricular drainage (EVD) and intrathecal urokinase.",[378,379],"Intraventricular Hemorrhage","Cerebral Hemorrhage",[378,381,382,383,384,385],"Lumbar Drainage","External Ventricular Drainage","Urokinase","PROBE design","Randomized Controlled Trial","NOT_YET_RECRUITING","2026-06-03",{"date":389,"type":390},"2026-06-04","ACTUAL",{"date":392,"type":372},"2026-06",{"date":394,"type":372},"2029-10",{"name":5,"class":6},29]