Intraventricular Hemorrhage of Infancy
(IVH; Subependymal Germinal Matrix Hemorrhage; SHE; Early-onset Germinal Matrix Hemorrhage; EGMH; Periventricular-Intraventricular Hemorrhage; PIVH)
Pronounced: In-tra-ven-tric-ooh-lar Hem-or-age of In-fan-see
Intraventricular hemorrhage (IVH) occurs when small blood vessels burst and bleed into the ventricles of a baby’s brain. The ventricles are spaces in the brain. These spaces are full of cerebrospinal fluid (CSF). In most cases, the bleeding gradually stops. The blood vessels heal themselves. Surgery may not be needed. If brain tissue is damaged, the baby may have long-term problems with development. IVH is most common in premature]]> babies.
Ventricles of the Brain
It is often not clear why IVH occurs. Changes in blood pressure in the baby’s brain may cause immature blood vessels to rupture (burst). This may occur during the first 48 hours after birth.
These factors increase your baby’s chance of developing IVH:
- Low birth weight
- Direct trauma to the baby’s head during birth (eg, pressure caused by hip bone, forceps, or vacuum)
- Breathing complications at birth
In many cases, there are no visible signs of IVH. If your baby has any of the following symptoms, do not assume it is due to IVH. These symptoms may be caused by other conditions. The hospital staff will examine your baby to see if he has:
- Swelling of fontanelles at the top of the head (soft spots between the bones of the skull)
- Apnea]]> (pauses in breathing)
- Muscle spasms
- Pale or blue color
- Weak suck
The doctor will do a physical exam of your infant. The doctor will look for any signs of injury in the brain. The following tests may be used:
- Ultrasound—a test that uses sound waves to examine the baby’s head to look for burst blood vessels and bleeding; often used to make the diagnosis
- Other tests (eg, blood tests to check for anemia, metabolic acidosis, infection)
Talk with your doctor about the best treatment plan for your baby. Treatment options include the following:
- Monitoring your baby’s condition to make sure it remains stable
- Treating any other medical conditions
- Having procedures done—If too much fluid builds up in the brain, it can cause damage to the brain. Examples of procedures that may need to be done include:
- Lumbar puncture]]>, fontanelle tap, or surgery—to drain fluid from your baby's brain
- Ventriculoperitoneal shunt—a tube that runs from the ventricle, under the skin, and into the baby's abdomen to drains fluid from the brain
American Academy of Neurology
American Academy of Pediatrics
Canadian Pediatric Society
Children’s Hospital Boston. Intraventricular hemorrhage. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1185/mainpageS1185P0.html. Accessed April 20, 2010.
DynaMed Editorial Team. Intraventricular hemorrhage in infancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 29, 2009. Accessed April 20, 2010.
Hill A. Intraventricular hemorrhage in the term newborn. In Bradley WG, Daroff RB, Fenichel G, Jankovic J. Neurology in Clinical Practice. 5th ed. Burlington, MA: Butterworth-Heinemann; 2008.
Last reviewed April 2010 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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