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Intraventricular Hemorrhage of Infancy

(IVH; Subependymal Germinal Matrix Hemorrhage; Early-onset Germinal Matrix Hemorrhage; EGMH; Periventricular-Intraventricular Hemorrhage; PIVH)

Definition

Intraventricular hemorrhage (IVH) is bleeding into the spaces of a baby’s brain. It may cause harm to brain tissue and lead to long-term development problems.
Ventricles of the Brain
Ventricles of the Brain
Copyright © Nucleus Medical Media, Inc.

Causes

IVH is caused by the rupture of immature or fragile blood vessels in the brain. It is not known why this happens, but changes in blood pressure may play a role.

Risk Factors

IVH is most common in premature babies and those with a low birth weight.

Symptoms

IVH often happens in the first 48 hours after birth. Most babies do not have symptoms. Those who do may have:
  • Seizures
  • Low muscle tone
  • Muscle spasms
  • Problems breathing, such as pauses in breathing
  • Pedaling leg motions
  • Changes is eye movement or alignment
  • Pale or blue skin color

Diagnosis

The diagnosis is often made during a routine ultrasound in premature or low birth weight infants. Blood tests may be done to support the diagnosis.

Treatment

The goal of treatment is to stop bleeding and lower the chances of problems that may happen from it.
Certain procedures or surgery may need to be done to ease pressure in the brain:
  • Ventriculoperitoneal shunt—a tube that runs under the skin and lets fluid drain from the ventricle (brain) to the abdomen
  • Lumbar puncture, fontanelle tap, or surgery—to drain fluid from the baby's brain

Prevention

Women at risk of having a premature baby may be given medicine to lower the risk of IVH in the baby.

RESOURCES

American Academy of Neurology
http://www.aan.com
Healthy Children—American Academy of Pediatrics
http://healthychildren.org

CANADIAN RESOURCES

Caring for Kids—Canadian Pediatric Society
http://www.caringforkids.cps.ca
Health Canada
https://www.canada.ca

References

Intraventricular hemorrhage. About Kids Health—The Hospital for Sick Children website. Available at: http://www.aboutkidshealth.ca/En/ResourceCentres/PrematureBabies/AboutPrematureBabies/BrainandBehaviour/Pages/Intraventricular-Hemorrhage-IVH.aspx. Updated October 31, 2009. Accessed January 2, 2020.
Intraventricular hemorrhage of infancy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/intraventricular-hemorrhage-of-infancy. Updated November 4, 2019. Accessed January 2, 2020.
Intraventricular hemorrhage. Stanford Children's Health website. Available at: http://www.stanfordchildrens.org/en/topic/default?id=intraventricular-hemorrhage-90-P02608. Accessed January 2, 2020.
Whitelaw A, Aquilina K. Management of posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal Neonatal Ed. 2012 May;97(3):F229-F233.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 06/12/2020
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