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Updated: Jul 10, 2026
Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Diagnostic neuroimaging and early detection of germinal matrix hemorrhage-intraventricular hemorrhage
Mehmet N Cizmeci1, Lara M Leijser2, Linda S de Vries3
1Division of Neonatology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Canada.
Insights
Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is a common brain injury in preterm infants. Neuroimaging like cranial ultrasonography and MRI aids in early detection and monitoring of this condition.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
Background:
- Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is a frequent brain injury in very preterm infants.
- Early detection and monitoring are crucial for managing GMH-IVH and its complications.
Purpose of the Study:
- To review neuroimaging modalities used in neonatal intensive care units for detecting GMH-IVH.
- To highlight the roles of cranial ultrasonography (cUS) and magnetic resonance imaging (MRI) in managing preterm infants with GMH-IVH.
Main Methods:
- Review of current literature on neuroimaging techniques for GMH-IVH detection in neonates.
- Comparison of cranial ultrasonography (cUS) and magnetic resonance imaging (MRI) capabilities.
Main Results:
- Cranial ultrasonography (cUS) is the primary tool for diagnosing and monitoring GMH-IVH.
- Brain MRI offers superior detection of subtle hemorrhages, white matter injury, and cerebellar hemorrhages, providing prognostic insights.
- GMH-IVH, particularly with complications, is linked to significant neurodevelopmental impairment.
Conclusions:
- Neuroimaging plays a vital role in the diagnosis, grading, and monitoring of GMH-IVH in preterm infants.
- While cUS is widely used, MRI provides more detailed information for complex cases and prognostication.
Abstract:
Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) continues to be a common form of brain injury in very preterm infants. Cranial ultrasonography (cUS) is the most widely used neuroimaging modality for the diagnosis of GMH-IVH, and serial cUS enables early detection, accurate grading, and monitoring of complications. Brain magnetic resonance imaging (MRI) is being used more commonly in neonates and is superior to cUS for detecting subtle hemorrhages in the temporal and occipital regions, concurrent white matter injury, and cerebellar hemorrhage, as well as for providing prognostic information. Despite major advances in perinatology and neonatology, GMH-IVH remains associated with high rates of neurodevelopmental impairment, especially when complicated by progressive post-hemorrhagic ventricular dilatation or periventricular hemorrhagic infarction. In this review, we present the neuroimaging modalities used in the neonatal intensive care unit and their role in the detection of GMH-IVH, with a focus on preterm infants.
