Intraventricular hemorrhage in full-term neonates

The neuropathological and general pathological features of intraventricular hemorrhage are described in 32 neonates who had been born at term. Although the most common site of bleeding was the choroid plexus, a significant minority occurred in the subependymal germinal matrix. Associated neuropathological findings included meningeal venous congestion, periventricular white-matter necrosis and subarachnoid hemorrhage. Pulmonary hemorrhages, hyaline membranes and congenital heart-defects were common. Most of the infants had low Apgar scores at birth and lived for less than two days. Significant neurological findings included hypotonia, hyporeflexia, decreased activity level and seizures. Clinical signs had not been reliable enough to differentiate distressed neonates with intraventricular hemorrhage from those without. Intraventricular hemorrhage should be considered in both term and premature neonates who sustain perinatal asphyxia or who later develop evidence of neurological deterioration.