Germinal matrix hemorrhage (grading)

Changed by Ayush Goel, 16 May 2016

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Grading of germinal matrix haemorrhage 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~~/germinal matrix which is seen in the caudothalamic groove
- overall good prognosis ⁴
grade II
- extension into normal sized ventricles and typically filling less than 50% of the volume of the ventricle
- overall good prognosis ⁴
grade III
- extension into dilated ventricles
- ~~~ 20~~~20% mortality
grade IV
- grade III with parenchymal haemorrhage
- 90% mortality ⁴

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

~~-<li>restricted to subependymal region / germinal matrix which is seen in the <a href="/articles/caudothalamic-groove">caudothalamic groove</a>~~
+<li>restricted to subependymal region/germinal matrix which is seen in the <a href="/articles/caudothalamic-groove">caudothalamic groove</a>
~~-<li>~ 20% mortality</li>~~
+<li>~20% mortality</li>

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