Germinal matrix hemorrhage (grading)
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Several grading systems have been used for neonatal intracranial germinal matrix haemorrhages. Commonly used is the sonographic grading system proposed by Burstein and Papile et.al:
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grade I
- restricted to subependymal region / germinal matrix which is seen in the caudothalamic groove
- overall good prognosis 4
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grade II
- extension into normal sized ventricles and typically filling less than 50% of the volume of the ventricle
- overall good prognosis 4
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grade III
- extension into dilated ventricles
- ~ 20% mortality
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grade IV
- grade III with parenchymal haemorrhage
- 90% mortality 4
- it should be noted that it is now thought that grade IV bleeds are not simply extensions of germinal matrix haemorrhage into adjacent brain, but rather represent sequelae of venous infarction 5.
-<p>Several grading systems have been used for neonatal intracranial <a href="/articles/germinal-matrix-haemorrhage" title="germinal matrix haemorrhage">germinal matrix haemorrhages</a>. Commonly used is the sonographic grading system proposed by <strong style="font-size: 12px; line-height: 1.5;">Burstein</strong> and <strong style="font-size: 12px; line-height: 1.5;">Papile</strong> et.al:</p><ul>-<li>- +<p>Several grading systems have been used for neonatal intracranial <a href="/articles/germinal-matrix-haemorrhage">germinal matrix haemorrhages</a>. Commonly used is the sonographic grading system proposed by <strong>Burstein</strong> and <strong>Papile</strong> et.al:</p><ul>
- +<li>
-<li>restricted to subependymal region / germinal matrix which is seen in the <a href="/articles/caudothalamic-groove" title="Caudothalamic groove">caudothalamic groove</a>-</li>- +<li>restricted to subependymal region / germinal matrix which is seen in the <a href="/articles/caudothalamic-groove">caudothalamic groove</a>
- +</li>
-</li>- +</li>
-</li>-<li>- +</li>
- +<li>
-<li>extension into <strong>normal </strong>sized <a href="/articles/ventricular-system" title="Ventricles of the brain">ventricles</a> and typically filling less than 50% of the volume of the ventricle</li>- +<li>extension into <strong>normal </strong>sized <a href="/articles/ventricular-system">ventricles</a> and typically filling less than 50% of the volume of the ventricle</li>
-</li>- +</li>
-</li>-<li>- +</li>
- +<li>
-<li>extension into <strong>dilated </strong>ventricles</li>-<li>~ 20% mortality</li>- +<li>extension into <strong>dilated </strong>ventricles</li>
- +<li>~ 20% mortality</li>
-</li>-<li>- +</li>
- +<li>
-<li>grade III with parenchymal haemorrhage <a href="/articles/cerebral-venous-infarction" title="Cerebral venous infarction"></a>-</li>- +<li>grade III with parenchymal haemorrhage</li>
-</li>-<li>it should be noted that it is now thought that grade IV bleeds are not simply extensions of germinal matrix haemorrhage into adjacent brain, but rather represent sequelae of <a href="/articles/cerebral-venous-infarction" title="Cerebral venous infarction">venous infarction</a> <sup>5</sup>.</li>- +</li>
- +<li>it should be noted that it is now thought that grade IV bleeds are not simply extensions of germinal matrix haemorrhage into adjacent brain, but rather represent sequelae of <a href="/articles/cerebral-venous-infarction">venous infarction</a> <sup>5</sup>.</li>
-</li>- +</li>
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Image 1 Ultrasound ( update )
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Case 21 - grade I germinal matrix haemorrhage
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Image 2 CT (non-contrast) ( update )
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Case 42 - grade I GMH
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Image 3 Ultrasound (Longitudinal) ( create )
Image 4 Ultrasound ( update )
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Case 14 - grade III germinal matrix haemorrhage
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Image 5 CT (non-contrast) ( update )
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Case 35 - grade III
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