Germinal matrix hemorrhage (grading)

Last revised by Bahman Rasuli ◉ on 16 Oct 2020

Citation, DOI & article data

Citation:

Weerakkody Y, Rasuli B, Iqbal S, et al. Germinal matrix hemorrhage (grading). Reference article, Radiopaedia.org (Accessed on 09 Dec 2022) https://doi.org/10.53347/rID-7600

DOI:

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

Permalink:

https://radiopaedia.org/articles/7600?iframe=true

rID:

7600

Article created:

11 Nov 2009 by Yuranga Weerakkody ◉

Revisions:

34 times by 12 users - see full revision history

System:

Paediatrics

Section:

Classifications

Tags:

Synonyms:

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

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
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% mortality
grade IV
- grade III with parenchymal hemorrhage
- 90% mortality ⁴

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.