PERIVENTRICULAR HEMORRHAGE

Classified into 4 grades in the neonate (1):

1. Grade 1. Germinal matrix hemorrhage or hemorrhage confined to the subependymal area of the brain.
2. Grade 2. Intraventricular hemorrhage with no hydrocephalus.
3. Grade 3. Intraventricular hemorrhage with ventricular dilatation.
4. Grade 4. Intraventricular hemorrhage with parenchymal hemorrhage and hydrocephalus.

ULTRASOUND

• Echogenic focus in ventricles or cortex.
• From 2 days to 2 weeks the inner portions of the hematoma become hypoechoic (liquefaction of the clot). The outer border remains echogenic and sharply demarcated from the surrounding brain parenchyma.
• Clot decreases in size due to clot retraction.
• Porencephalic cyst becomes evident as the clot retracts.
• Hydrocephalus (frequently asymmetric) may result.
• Subependymal cysts are a common result.
• Encephalomalacia is very difficult to detect antenatally.

	Echogenic subependymal hemorrhage at 29 weeks of gestation at the caudothalamic groove. Etiology – not known.

REFERENCES

1. Papile LA, Burstein J, Burstein R et.al. Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gm. J Pediatrics 1978;92:529-534.