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Preterm Hemorrhagic Brain Injury: Recent Advances on Evaluation and Management

Rhandi Christensen1, Mehmet N Cizmeci2, Linda S de Vries3

  • 1Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 175 Elizabeth Street, Room 18-14-053, Toronto, ON M5G 2G3, Canada.

Clinics in Perinatology
|May 11, 2025
PubMed

Insights

Preterm infants face risks of germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH). This review covers GMH-IVH causes, evaluation, management, and neurodevelopmental outcomes.

Area of Science:

  • Neonatal Neurology
  • Pediatric Neuroimaging
  • Perinatal Medicine

Background:

  • Preterm infants are susceptible to germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH).
  • GMH-IVH can progress to posthemorrhagic ventricular dilatation (PHVD) and periventricular hemorrhagic infarction.
  • Understanding these injuries is crucial for timely intervention.

Purpose of the Study:

  • To review the pathophysiology and presentation of preterm hemorrhagic brain injury.
  • To provide recommendations for the evaluation and management of GMH-IVH and PHVD.
  • To discuss emerging therapies and neurodevelopmental outcomes.

Main Methods:

  • Comprehensive literature review.
  • Analysis of current diagnostic and management strategies.
  • Synthesis of evidence on emerging treatments.

Main Results:

  • Cranial ultrasound is the primary neuroimaging tool for GMH-IVH screening and monitoring.
  • Optimal timing for cranial ultrasound scans is discussed.
  • Key management strategies and novel therapies for PHVD are presented.

Conclusions:

  • Early and accurate diagnosis of GMH-IVH is essential for effective management.
  • Current management focuses on preventing complications and optimizing outcomes.
  • Further research into emerging therapies may improve neurodevelopmental trajectories in affected infants.

Keywords:
HydrocephalusIntraventricular hemorrhageNeurodevelopmental outcomeNewbornPretermTreatment

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