Neonatal intraventricular hemorrhage: grade 2

Case contributed by Sam Kruger
Diagnosis certain

Presentation

25 week premature infant treated for mid-gut volvulus.

Patient Data

Age: 9 days old
Gender: Male
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Info

Selected images from a cranial ultrasound study demonstrates a small left sided ventricular hemorrhage within the caudothalamic groove. There is extension of blood into the body of the left lateral ventricle. 

This is a grade II IVH due to extension into the nondilated ventricles. 

Case Discussion

The ventricular system of premature infants contains a germinal matrix which lies within the caudothalamic groove (space between caudate head and thalamus). The germinal matrix is highly vascular and serves as a stem source for neuroblasts in-utero. It typically involutes by term. 

Hemorrhage into the germinal matrix commonly occurs in premature infants during first 3 days of life. Complications include destruction of precursor cells within germinal matrix, hydrocephalus and hemorrhagic infarction of periventricular tissues. 

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