Germinal matrix hemorrhage (grading)

Last revised by Rohit Sharma on 17 Jan 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Sharma R, Ibrahem H, et al. Germinal matrix hemorrhage (grading). Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-7600

DOI:

https://doi.org/10.53347/rID-7600

Permalink:

https://radiopaedia.org/articles/7600

rID:

7600

Article created:

11 Nov 2009, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

17 Jan 2024, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

19 times, by 17 contributors - see full revision history and disclosures

Systems:

Central Nervous System, Paediatrics

Sections:

Classifications

Synonyms:

Germinal matrix hemorrhage grading
Grading of neonatal intracranial haemorrhages
Grading of neonatal intracranial hemorrhage
Grading of neonatal intracranial hemorrhages
Grading of neonatal intracranial haemorrhage
Bustein and Papile grading
Bustein and Papile classification

Grading of germinal matrix hemorrhage has taken several forms over the years. The most commonly used system is the sonographic grading system proposed by Burstein, Papile, et al.

Classification

grade I
- restricted to subependymal region/germinal matrix which is seen in the caudothalamic groove
- overall good prognosis ⁴
- 3.1% mortality ⁷
grade II
- extension into normal-sized ventricles and typically filling less than 50% of the volume of the ventricle
- overall good prognosis ⁴
- 7.8% mortality ⁷
grade III
- extensive hemorrhage with distension/dilation of the ventricles
- 21.3% mortality ⁷
grade IV
- parenchymal involvement
- 36.1% mortality ⁷

It was initially postulated that grade IV IVH represented parenchymal extension of ventricular hemorrhage. It is now recognized that grade IV IVH represents parenchymal hemorrhage secondary to venous infarction caused by compression of deep terminal veins by an expanded ventricle filled with blood.

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