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  • Updated 04.01.2024
  • Released 09.05.2012
  • Expires For CME 04.01.2027

Neonatal intraventricular hemorrhage



In this article, the authors review intraventricular hemorrhage in preterm and full-term neonates, covering symptomatology, etiology, management, and outcomes. Survival rates among preterm infants have continued to improve, and the number of infants with intraventricular hemorrhage and its neurodevelopmental sequelae has also risen (01; 25). As such, understanding this condition is crucial for clinicians.

Key points

• Intraventricular hemorrhage originates in the germinal matrix of the infant born at less than 34 weeks’ gestation.

• Intraventricular hemorrhage results from brain blood flow perturbations brought on by defective cerebral autoregulation in association with the various comorbidities of prematurity.

• Management of intraventricular hemorrhage consists of monitoring for ventricular dilation and impaired drainage of CSF.

• Neurologic sequelae may be severe and are related to both the severity and location of the hemorrhage.

Historical note and terminology

The advent of widespread positive pressure mechanical ventilation in the 1970s resulted in an approximately 300% increase in the incidence of intraventricular hemorrhage. The later use of antenatal steroids and surfactant administration as well as more stringent resuscitation policies to protect against significant fluctuations in cerebral blood flow did a lot to decrease the incidence of intraventricular hemorrhage in the 1990s (36). The number of infants born prematurely or at low birth weight in the U.S. continues to increase, and many more of these infants survive. Improved survivorship among these fragile infants means that cases of intraventricular hemorrhage remain prevalent in neonatal medicine (25).

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