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Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
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Preterm brain injury: Germinal matrix-intraventricular hemorrhage and post-hemorrhagic ventricular dilatation

Lara M Leijser1, Linda S de Vries2

  • 1Department of Pediatrics, Section of Neonatology, University of Calgary, Cumming School of Medicine, Calgary, Canada.

Handbook of Clinical Neurology
|July 21, 2019
PubMed

Insights

Germinal matrix hemorrhage and intraventricular hemorrhages (GMH-IVH) are common in preterm infants. Early cerebrospinal fluid drainage for posthemorrhagic ventricular dilation (PHVD) may improve neurodevelopmental outcomes.

Area of Science:

  • Neonatal neurology
  • Pediatric neurosurgery
  • Developmental neuroscience

Background:

  • Germinal matrix hemorrhage and intraventricular hemorrhages (GMH-IVH) are significant concerns in preterm infants, especially those born extremely prematurely.
  • GMH-IVH can lead to complications like posthemorrhagic ventricular dilation (PHVD), parenchymal damage, and long-term neurological issues.
  • Advances in neuroimaging, including ultrasonography and MRI, have improved the detection and understanding of GMH-IVH and associated brain injuries.

Purpose of the Study:

  • To provide a comprehensive overview of germinal matrix hemorrhage and intraventricular hemorrhages (GMH-IVH) and posthemorrhagic ventricular dilation (PHVD).
  • To discuss the pathogenesis, incidence, and risk factors associated with GMH-IVH and PHVD.
  • To review current management strategies, including preventive measures and emerging treatments for these conditions.

Main Methods:

  • Review of existing literature on GMH-IVH and PHVD.
  • Analysis of data from cranial ultrasonography and MRI studies.
  • Discussion of clinical outcomes and neurodevelopmental follow-up.

Main Results:

  • Cranial ultrasonography has aided in decreasing GMH-IVH incidence and identifying risk factors.
  • MRI provides detailed visualization of GMH-IVH extent and associated white matter/cerebellar changes.
  • Early cerebrospinal fluid drainage for PHVD is linked to improved neurodevelopmental outcomes.

Conclusions:

  • GMH-IVH and PHVD remain challenging conditions in preterm neonates.
  • While prevention is not yet possible, early intervention strategies like CSF drainage show promise.
  • Ongoing research aims to enhance treatment and develop methods for preventing and repairing GMH-IVH and PHVD-related brain injury.

Keywords:
BrainCerebellumHemorrhagePosthemorrhagic ventricular dilationPretermWhite matter

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