Lumbar Drainage of Intraventricular Hemorrhage

NCT ID: NCT06510842

Last Updated: 2026-01-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

354 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-16

Study Completion Date

2029-07-31

Brief Summary

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Intracerebral hemorrhage (ICH) is a debilitating and fatal disease, especially when the hemorrhage is also entering the cerebral ventricles leading to acute hydrocephalus. In these cases, patients need a drainage through external ventricular drains (EVD). In the longer term, patients often need a permanent ventriculoperitoneal (VP) shunt to avoid hydrocephalus. Here we hypothesize that the early insertion of a lumbar drainage in addition to the EVD could lead to better functional outcome and avoidance of VP shunting by drainage of the blood which promotes inflammatory and adverse effects in the subarachnoid space. For that we propose a multi-center randomized clinical trial to investigate the hypothesis.

Detailed Description

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Conditions

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Intraventricular Hemorrhage Lumbar Drainage External Ventricular Drainage

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention arm

Additional insertion of a lumbar drainage.

Group Type EXPERIMENTAL

External drainage of intraventricular hemorrhage

Intervention Type OTHER

An EVD is required to be eligible for the DRAIN IVH study. Weaning from the EVD is at the discretion of the local investigators. Imaging is at discretion of local investigators. Use, timing and frequency of fibrinolysis via EVD is at local discretion, too.

Control arm

Standard of care consists of drainage of CSF via EVD with or without intraventricular thrombolysis.

Group Type ACTIVE_COMPARATOR

External drainage of intraventricular hemorrhage

Intervention Type OTHER

An EVD is required to be eligible for the DRAIN IVH study. Weaning from the EVD is at the discretion of the local investigators. Imaging is at discretion of local investigators. Use, timing and frequency of fibrinolysis via EVD is at local discretion, too.

Interventions

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External drainage of intraventricular hemorrhage

An EVD is required to be eligible for the DRAIN IVH study. Weaning from the EVD is at the discretion of the local investigators. Imaging is at discretion of local investigators. Use, timing and frequency of fibrinolysis via EVD is at local discretion, too.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ICH with IVH (with hemorrhage in the 3rd and/or 4rth ventricle) with the need for EVD placement due to acute hydrocephalus
* Age ≥ 18 y
* Lumbar drain can be inserted within 72 h after symptom onset or patient last seen well

Exclusion Criteria

* Premorbid mRS score \> 2
* Pregnancy
* Life expectancy \<6 months
* Patient/family/caregiver unwilling or unlikely to opt for at least two weeks of aggressive therapy prior to consideration of transition to comfort measures/discontinuation of life support measures.
* Treating physicians deeming the prognosis as so grave that an aggressive therapy is not warranted.
* Other clear contraindication for treatment with a lumbar drain
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Heidelberg

OTHER

Sponsor Role lead

Responsible Party

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Dr. Silvia Schönenberger, MD

Prof. Dr. Silvia Schönenberger

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Silvia Schönenberger, MD

Role: PRINCIPAL_INVESTIGATOR

Heidelberg University Hospital, Department of Neurology

Locations

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Department of Neurology, University Hospital Heidelberg

Heidelberg, Baden-Wurttemberg, Germany

Site Status RECRUITING

LMU München

München, Bavaria, Germany

Site Status RECRUITING

Augsburg University Hospital

Augsburg, , Germany

Site Status RECRUITING

Charite Universitätsmedizin Berlin

Berlin, , Germany

Site Status NOT_YET_RECRUITING

Düsseldorf Universitiy Hospital

Düsseldorf, , Germany

Site Status RECRUITING

Frankfurt University Hospital

Frankfurt, , Germany

Site Status NOT_YET_RECRUITING

Goettingen University Hospital

Göttingen, , Germany

Site Status NOT_YET_RECRUITING

Augsburg University Hospital Department of Neurosurgery

Heidelberg, , Germany

Site Status RECRUITING

Heidelberg University Hospital Department of Neurosurgery

Heidelberg, , Germany

Site Status RECRUITING

Mainz University Hospital

Mainz, , Germany

Site Status NOT_YET_RECRUITING

Mannheim University Hospital

Mannheim, , Germany

Site Status RECRUITING

Osnabrück Clinic

Osnabrück, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Silvia Schönenberger, MD

Role: CONTACT

0049/6221/567504

Min Chen, MD

Role: CONTACT

0049/6221/567504

Facility Contacts

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Silvia Schönenberger, Dr.

Role: primary

0049-6221-5637549

Konstantinos Dimitriadis, Prof. Dr.

Role: primary

004989440073690

Hauke Schneider, PD Dr.

Role: primary

0049/821/400-01

Stefan Wolf, Dr.

Role: primary

Kerim Beseoglu, Prof. Dr.

Role: primary

+49 (0) 2 11-81 00

Marcus Czabanka, Prof. Dr.

Role: primary

049/69 63010

Tammam Abboud, PD Dr.

Role: primary

049/551/390

Nadine Lilla, PD Dr.

Role: primary

0049/821 400-01

Martin Jakobs, Prof. Dr.

Role: primary

0049/6221/560

Thomas Kerz, Dr.

Role: primary

+49 6131 39-0

Christopher Beynon, Prof. Dr.

Role: primary

0049/621/383-0

Volker Schulte, Dr.

Role: primary

049/541/4050

References

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Staykov D, Kuramatsu JB, Bardutzky J, Volbers B, Gerner ST, Kloska SP, Doerfler A, Schwab S, Huttner HB. Efficacy and safety of combined intraventricular fibrinolysis with lumbar drainage for prevention of permanent shunt dependency after intracerebral hemorrhage with severe ventricular involvement: A randomized trial and individual patient data meta-analysis. Ann Neurol. 2017 Jan;81(1):93-103. doi: 10.1002/ana.24834.

Reference Type BACKGROUND
PMID: 27888608 (View on PubMed)

Staykov D, Huttner HB, Struffert T, Ganslandt O, Doerfler A, Schwab S, Bardutzky J. Intraventricular fibrinolysis and lumbar drainage for ventricular hemorrhage. Stroke. 2009 Oct;40(10):3275-80. doi: 10.1161/STROKEAHA.109.551945. Epub 2009 Aug 13.

Reference Type BACKGROUND
PMID: 19679848 (View on PubMed)

Kuramatsu JB, Gerner ST, Ziai W, Bardutzky J, Sembill JA, Sprugel MI, Mrochen A, Kolbl K, Ram M, Avadhani R, Falcone GJ, Selim MH, Lioutas VA, Endres M, Zweynert S, Vajkoczy P, Ringleb PA, Purrucker JC, Volkmann J, Neugebauer H, Erbguth F, Schellinger PD, Knappe UJ, Fink GR, Dohmen C, Minnerup J, Reichmann H, Schneider H, Rother J, Reimann G, Schwarz M, Bazner H, Classen J, Michalski D, Witte OW, Gunther A, Hamann GF, Lucking H, Dorfler A, Ishfaq MF, Chang JJ, Testai FD, Woo D, Alexandrov AV, Staykov D, Goyal N, Tsivgoulis G, Sheth KN, Awad IA, Schwab S, Hanley DF, Huttner HB; Collaborators. Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis. Stroke. 2022 Sep;53(9):2876-2886. doi: 10.1161/STROKEAHA.121.038455. Epub 2022 May 6.

Reference Type BACKGROUND
PMID: 35521958 (View on PubMed)

Other Identifiers

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S-304/2024

Identifier Type: OTHER

Identifier Source: secondary_id

DRAIN IVH

Identifier Type: -

Identifier Source: org_study_id

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